【摘要】 目的 观察伊贝沙坦对原发性高血压病患者多形核白细胞粘附分子CD11b/CD18 表达的影响及其保护肾脏的可能机制。方法 49例无临床肾病、非糖尿病的原发性高血压患者随机分成伊贝沙坦和氨氯地平治疗组 ,另设正常对照组。原发性高血压病患者治疗前后测定尿白蛋白排泄率、CD11b/CD18 的表达及肿瘤坏死因子-α水平等指标。结果 与正常对照组比较 ,原发性高血压病患者的CD11b/CD18 表达增高 ,肿瘤坏死因子 -α水平也明显增高 (P<0.01)。与氨氯地平治疗组比较 ,伊贝沙坦治疗3个月后 ,原发性高血压病患者的CD11b/CD18 表达、尿白蛋白排泄率和肿瘤坏死因子 -α明显降低 (均P<0.01)。尿白蛋白排泄率下降与肿瘤坏死因子 -α浓度降低和多形核白细胞粘附分子CD11b/CD18 表达的下降呈正相关 (r=0.55 ,0.64,均P<0.01)。结论 原发性高血压患者的多形核白细胞粘附分子CD11b/CD 18 表达增高 ;伊贝沙坦独立于降压作用外保护肾脏的机制可能与其抑制CD11b/CD18 表达有关。更多还原

【Abstract】 Objective To instivate effect of irbesarten on the expression of CD 11b /CD 18 in patients with essential hypertension(EH)and the possible mechanismof irbesarten on renal protection.Methods Forty-nine patients of essential hypertension without clinical nephropaty and diabetes were randomly divided into irbesarten group(n=26)and amlodipine group(n=23).Levels of blood pressure,age,sex,duration of hypertension were matched at entry.The treatment course was3months.The main changes of blood pressure,urinary albumin exˉcretion rate(UAER),tumor necrosis factor-α(TNF-α)and the expression of CD 11b /CD 18 before and after treatment were observed.Results Levels of TNF-αand the expression of CD 11b /CD 18 in patients with EH were higher than those in normal controls.There were no significant differences in UAER,TNF-αand the expression of CD 11b /CD 18 between the irbesarten group and amlodipine group,but at the end of the3th months,the paˉrameters in irbesarten group were significantly lower than those in amlodipine group(P<0.01).By correlation analysis,the decrement of UAER was positively correlated with the decrement of the levels of TNF-αand the expression of CD 11b /CD 18 (r=0.55,P<0.01and r=0.64,P<0.01).Conclusions(1)The expression of CD 11b /CD 18 and the levels of TNF-αincreased in patients with EH.(2)The renal protective effect of irbesarten is probably correlated with its inhibition on the expression of CD 11b /CD 18 in polymorphonuclear(PMN)leukoˉcytes.更多还原