【摘要】 目的探讨氢氯噻嗪(HCTZ)与卡托普利长期联合治疗对高血压患者肾素-血管紧张素-醛固酮系统(RAAS)活性及生化指标的影响。方法在9所开滦矿区医院筛选出轻、中度高血压患者,在2周洗脱期和6周HCTZ(12.5mg,1次/d)导入期后加服卡托普利(25mg,2次/d),治疗5a。于洗脱期末、导入期末、治疗2a和5a时检测RAAS活性,每年检测血生化指标,比较各时间点RAAS活性变化与生化指标变化。结果6周HCTZ导入期末,患者血浆血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)浓度较基线值升高,差别有统计学意义(P<0.01),血钠浓度下降(P<0.01);治疗2a时血浆AngⅡ、ALD和血钠浓度已恢复至基线水平,血糖浓度下降(P<0.01);治疗5a后,血钾浓度下降(P<0.01),而血糖、血钠、AngⅡ、ALD浓度变化与基线值比较,差别无统计学意义(P>0.05)。结论高血压患者长期合用HCTZ与卡托普利治疗后,RAAS活性可恢复至治疗前水平,对血糖浓度影响不大,而血钾降低。更多还原

【Abstract】 Objective To explore the effects of long-term treatment with hydrochlorothiazide combined Captopril on variety of renin-angiotensin-aldosterone system and biochemical parameters in hypertensive patients.Methods A multicenter study was performed and nine Kai-luan coal mining industry hospitals took part in the trial.After 2-weeks placebo elution period and 6-weeks hydrochlorothiazide leading period,the eligible patients with mild-moderate hypertension received hydrochlorothiazide(HCTZ,12.5 mg,qd.)and Captopril(25 mg,bid)for 5 years.The activity of RAAS and biochemical parameters were measured at the end of placebo elution period,6 weeks leading period,2 years and 5 years.Analysis was performed between the variety of RAAS and biochemical parameters.Results At the end of 6 weeks hydrochlorothiazide leading period,plasma angiotensin-Ⅱ(AngⅡ)and aldosterone(ALD)concentrations in the patients was significantly higher(P<0.01)while serum sodium was lower(P<0.05).After 2 years treatment,plasma AngⅡ,ALD and concentrations had restored to baseline level while glucose levels were significantly reduced compared with the levels of baseline.After 5 years treatment,compared with baseline level,potassium were significantly reduced(P<0.01)while AngⅡ,ALD and glucose were no difference.Conclusion Activity of RAAS would restore to the levels of baseline after long-term treatment with hydrochlorothiazide combined Captopril and there are no significant effects of variety of RAAS on glucose.However,potassium was reduced.更多还原