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目的:通过两两药物联合应用治疗高血压,对比药物联合治疗的降压效果,并探讨其对左室重构的作用。方法:用两肾一夹法建立高血压大鼠模型,65只SD大鼠随机分为:假手术组(n=10);高血压组(n=11);β-B+血管紧张素转化酶抑制剂(ACEI)组(n=11)予以比索洛尔5mg·kg-1·d-1及贝那普利5mg·kg-1·d-1灌胃;β-B+血管紧张素Ⅱ受体拮抗剂(ARB)组(n=11)予以比索洛尔5mg·kg-1·d-1及替米沙坦10mg·kg-1·d-1灌胃;ACEI+ARB组(n=11)予以贝那普利5mg·kg-1·d-1及替米沙坦10mg·kg-1·d-1灌胃;ACEI+钙拮抗剂(CCB)组(n=11)予以贝那普利5mg·kg-1·d-1及氨氯地平2.5mg·kg-1·d-1灌胃;期间每2周给大鼠测量鼠尾动脉压和超声心动图;20周后采集标本,用免疫组化法检测胶原Ⅲ、胶原Ⅳ及心钠素。结果:各用药组血压降低程度明显,其中ACEI+CCB组(P<0·01),与假手术组相近,且比其他用药组血压降低明显(P<0·05)。β-B+ACEI组和β-B+ARB组胶原Ⅲ、胶原Ⅳ含量较高血压组降低(P<0·05),ACEI+ARB组和ACEI+CCB组显著降低(P<0·01),ACEI+ARB组和ACEI+CCB组较β-B+ACEI组和ACEI+ARB组降低(P<0·05);与假手术组比较,高血压组心钠素明显升高(P<0·05),各药物治疗组心钠素无明显升高,与高血压组比较,各药物治疗组心钠素显著降低(P<0·01)。结论:在降压和靶器官保护方面,ACEI+CCB组疗效最好,ACEI+ARB组次之,β-B+ACEI组和β-B+ARB组较前2组效果差,且2组之间无明显差别。
OBJECTIVE: To compare the antihypertensive efficacy of the combination therapy of two drugs in the treatment of hypertension and to explore its effect on left ventricular remodeling. Methods: Hypertension rat model was established by two kidneys and one clip method. Sixty-five SD rats were randomly divided into sham operation group (n = 10), hypertension group (n = 11), β-B + angiotensin converting enzyme The rats in the ACEI group (n = 11) were treated with 5 mg · kg-1 · d-1 of bisoprolol and 5 mg · kg-1 · d-1 of benazepril. The β-B + angiotensin Ⅱ receptor (N = 11) were given intragastric administration of 5 mg · kg-1 · d-1 of bisoprolol and 10 mg · kg-1 · d-1 of telmisartan in the ARB group (n = 11) The patients were given benazepril 5mg · kg-1 · d-1 and telmisartan 10mg · kg-1 · d-1 orally; ACEI + calcium antagonist (CCB) · Kg-1 · d-1 and amlodipine 2.5mg · kg-1 · d-1 were intragastrically administered to the rats every 2 weeks during the rat tail arterial pressure and echocardiography; 20 weeks after the specimens were collected, with the immune Tissue method was used to detect collagen Ⅲ, collagen Ⅳ and atrial natriuretic peptide. Results: The blood pressure of each group was significantly reduced. The ACEI + CCB group (P <0.01) was similar to the sham operation group and significantly lower than the other groups (P <0.05). The levels of collagen Ⅲ and collagen Ⅳ in β-B + ACEI group and β-B + ARB group were significantly lower than those in high blood pressure group (P <0.05), but were decreased in ACEI + ARB group and ACEI + CCB group (P <0.05). The atrial natriuretic peptide in ACEI + ARB group and ACEI + CCB group was lower than that in β-B + ACEI group and ACEI + ARB group · 05), no significant increase in atrial natriuretic peptide in each drug treatment group, compared with the hypertension group, atrial natriuretic peptide was significantly decreased in each drug treatment group (P <0.01). CONCLUSION: ACEI + CCB group has the best effect on blood pressure lowering and target organ protection, followed by ACEI + ARB group, β-B + ACEI group and β-B + ARB group, compared with the former two groups No significant difference between.