【摘要】 目的 :探讨氨氯地平对原发性高血压 (EH)患者心肾的作用及其与细胞内胞浆游离钙 ([Ca2 + ] i)的关系。　　方法 :选择EH患者 90例 ,予氨氯地平治疗 6个月 ,治疗前后自身对照检测淋巴细胞内 [Ca2 + ] i,2 4小时动态血压 ,左心室重量指数 (LVMI) ,左心室舒张功能和肾功能指标等的变化。　　结果 :经氨氯地平治疗后 ,日间、夜间和 2 4小时收缩压和舒张压均显著下降 (P <0 0 1) ,降压谷 /峰值 :收缩压为 79% ,舒张压为 66%。氨氯地平治疗后 [Ca2 + ] i,LVMI和 2 4小时尿蛋白均显著下降 (P <0 0 1) ,左心室后壁厚度及舒张期室间隔厚度均显著下降 ,有显著性差异 (P <0 0 5 )。 [Ca2 + ] i的下降幅度与LVMI的下降幅度呈正相关 (γ =0 6675 ,P <0 0 5 ) ,[Ca2 + ] i的下降幅度与舒张早期血流峰值速度 /舒张晚期血流峰值速度 (E/A)值的上升幅度呈负相关(γ =-0 5 2 3 0 ,P <0 0 5 )。　　结论 :氨氯地平治疗EH可达到平稳降压、逆转左心室重构和肾功能损害的疗效 ,[Ca2 + ] i的降低可能参与其改善心肾功能作用。更多还原

【Abstract】 Objective:To investigate the relationship between intracellular free calcium concentration and the effect of amlodipine therapy on heart and renal functions in essential hypertensive patients. Methods:Ninety essential hypertensive patients were treated with amlodipine for six months,intralymphocytic free calcium concentration([Ca 2+ ] i),ambulatory blood pressure monitoring(ABPM),left ventricular mass index(LVMI),left ventricular function and the parameters of renal function were evaluated before and after trearment. Results:After 6 months of treatment,24 hours micro albuminuria was significantly decreased in sererity(p<0.01).The calculated T/P ratios were 79%(SBP) and 66%(DBP).After treatment,[Ca 2+ ] i,ABPM,LVMI were significantly decreased(p<0.01).Left ventricular function was significantly improved(p<0.05).The changes of [Ca 2+ ] i were correlated positively with LVMI(γ=0.6675,p<0.05),but negatively with E/A ratio (γ=-0.5230,p<0.05). Conclusion:The mechanisms of antihypertensive effect and improvement of heart and renal function by amlodipine therapy may be associated with the normalization of intracellular calcium metabolism.更多还原