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[卡托普利在改善血管结构和降低血压方面的作用]

[Captopril in improving vascular structure and lowering blood pressure].

作者信息

Chen D, Jin X, Chen S

机构信息

Hypertension Unit, First Affiliated Hospital, Fujian Medical College, Fuzhou.

出版信息

Zhonghua Yi Xue Za Zhi. 1995 Jun;75(6):355-9, 383-4.

PMID:7553149
Abstract

SHRs were given captopril 20 mg/kg/day (group A, n = 13) and 100 mg/kg/day (group B, n = 17) from intrauterus period to 16 weeks of age, then the treatment was removed. Experiments were carried out at 40 weeks. SBP, left ventricular mass/body weight ratio, wall/lumen ratio of branch III mesenteric and renal artery were determined. The perfusion pressure response to alpha 1 adrenergic agonist (phenylephrine) of resistance blood vessels in a hindquarter model in the presence of Nw-nitro-1-arginine-methyl ester (LNAME) or L-arginine were examined. Untreated SHR (n = 16) and untreated WKY (n = 17) served as controls. Both doses of captopril treatment completely prevented hypertrophy of vascular vessels to some extent comparable to that of the untreated WKY. But their SBP was still significantly higher than that of the untreated WKY. The curves of perfusion pressure responding to incremental doses of phenylephrine shifted rightward in the captopril treatment groups in a dose dependent manner. The curves of high dose group were almost identical to those of WKY, markedly different from that of the untreated SHR. Captopril decreased the over enhanced vasoconstrictor effect of LNAME in SHR. The attenuated vasoconstrictor effect by L-arginine was greatly augmented by captopril, suggesting that captopril improves the function of resistance of vessels by mediating endothelial cells. Captopril-induced alteration in vascular structure and function may be separated from its hypotensive effect. Clinically, continuing administration of captopril may be beneficial to the improvement of the vascular system in those blood pressure unresponsive patients.

摘要

从子宫内期至16周龄,给自发性高血压大鼠(SHR)分别灌胃卡托普利20mg/kg/天(A组,n = 13)和100mg/kg/天(B组,n = 17),之后停止给药。实验在40周龄时进行。测定收缩压、左心室质量/体重比、肠系膜动脉III级分支和肾动脉壁/腔比。在存在Nω-硝基-L-精氨酸甲酯(LNAME)或L-精氨酸的情况下,检测后肢模型中阻力血管对α1肾上腺素能激动剂(去氧肾上腺素)的灌注压反应。未治疗的SHR(n = 16)和未治疗的Wistar-Kyoto大鼠(WKY,n = 17)作为对照。两种剂量的卡托普利治疗在一定程度上完全预防了血管肥厚,其程度与未治疗的WKY相当。但它们的收缩压仍显著高于未治疗的WKY。卡托普利治疗组中,去氧肾上腺素递增剂量的灌注压反应曲线呈剂量依赖性右移。高剂量组的曲线几乎与WKY的相同,与未治疗的SHR明显不同。卡托普利降低了LNAME对SHR过度增强的血管收缩作用。卡托普利极大地增强了L-精氨酸减弱的血管收缩作用,提示卡托普利通过介导内皮细胞改善血管阻力功能。卡托普利引起的血管结构和功能改变可能与其降压作用无关。临床上,对血压无反应的患者持续给予卡托普利可能有利于改善血管系统。

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