Noroozianavval M, Argani H, Aghaeishahsavari M, Veisi P, Ghorbanihaghjo A, Rashtchizadeh N, Jabbarpourbonyadi M, Hamzeiy H
Drug Applied Research Center, Tabriz Medical University, Tabriz, Iran.
Transplant Proc. 2007 May;39(4):1018-22. doi: 10.1016/j.transproceed.2007.02.016.
In this study, hemoglobin (Hb) concentrations secondary to enalapril (E) or losartan (L) therapy were evaluated with respect to renin-angiotensin system (RAS) polymorphisms in renal transplant recipients.
After determination of RAS polymorphisms [angiotensin-converting enzyme (DD, non-DD), angiotensinogen (TT, non-TT), and angiotensin receptor type 1 (CC, non-CC)] by polymerase chain reaction, 70 renal transplant recipients were recruited to four groups randomly: first and second groups were treated with E (10 mg/d, 15 patients) and L (50 mg/d, 20 patients) alone, respectively. The third group received E+L (10 mg/d + 50 mg/d, 13 patients) and the fourth group (22 patients) received no medication. The treatment protocol was followed for 16 weeks. Complete blood counts were checked before treatment and every 2 months. P<.05 was considered to indicate statistical significance.
Treatment for 4 months decreased the Hb level in the E+L (14.15 +/- 0.94 to 12.06 +/- 0.66 g/dL, P=.000), E (14.00 +/- 0.86 to 13.11 +/- 0.82 g/dL, P=.02), and L (14.12 +/- 0.90 to 12.10 +/- 2.35 g/dL, P=.01) groups, but not in the control group (13.55 +/- 0.70 to 13.36 +/- 0.69 g/dL, P>.05). None of these regimens showed greater Hb reduction than the others (P>.05). None of the RAS polymorphisms predicted the intensity of the reduced Hb according to the type of treatment (P>.05). Any other sets of RAS polymorphisms (alone or together) did not impact on Hb levels pre- or post-intervention (P>.05).
Our findings suggest that low dosages of E and/or L decrease Hb levels regardless of the RAS polymorphisms.
在本研究中，针对肾移植受者肾素 - 血管紧张素系统（RAS）多态性，评估了依那普利（E）或氯沙坦（L）治疗后继发的血红蛋白（Hb）浓度。
通过聚合酶链反应确定RAS多态性[血管紧张素转换酶（DD，非DD）、血管紧张素原（TT，非TT）和1型血管紧张素受体（CC，非CC）]后，70名肾移植受者被随机分为四组：第一组和第二组分别单独接受E（10毫克/天，15例患者）和L（50毫克/天，20例患者）治疗。第三组接受E + L（10毫克/天 + 50毫克/天，13例患者），第四组（22例患者）不接受药物治疗。治疗方案持续16周。治疗前及每2个月检查一次全血细胞计数。P <.05被认为具有统计学意义。
治疗4个月后，E + L组（从14.15±0.94降至12.06±0.66克/分升，P =.000）、E组（从14.00±0.86降至13.11±0.82克/分升，P =.02）和L组（从14.12±0.90降至12.10±2.35克/分升，P =.01）的Hb水平降低，但对照组（从13.55±0.70降至13.36±0.69克/分升，P>.05）未降低。这些治疗方案中，没有一种显示出比其他方案更大程度的Hb降低（P>.05）。根据治疗类型，没有一种RAS多态性能够预测Hb降低的强度（P>.05）。任何其他RAS多态性组合（单独或联合）在干预前后均未对Hb水平产生影响（P>.05）。
我们的研究结果表明，低剂量的E和/或L会降低Hb水平，与RAS多态性无关。
