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1.
研究怀菊花总黄酮对自发性高血压大鼠(SHR)的降压作用及其机制。将SHR随机分为模型组、怀菊花总黄酮高、中、低剂量组和依那普利阳性对照组。采用无创血压计测定血压及心率,采用放射免疫法测定血浆内皮素(ET)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、肾素活性(PRA)含量。结果表明怀菊花总黄酮能够降低SHR的血压(P0.01)、心率(P0.05)、血浆ET(P0.05)、AngⅡ(P0.01)、ALD(P0.01)、PRA(P0.01),其降压机制可能与改善内皮功能和抑制肾素-血管紧张素-醛固酮系统(RAAS)活性有关。  相似文献   

2.
目的:探讨益气温阳活血利水法治疗心肾综合征的临床疗效及对患者心肾功能及血浆脑钠肽(BNP)、肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平的影响。方法:研究对象为本院2017年3月~2018年9月收治的124例心肾综合征患者,采用随机数字表将其分成观察组与对照组,每组62例。两组患者均给予常规西医对症治疗,观察组同时给予中医益气温阳活血利水法治疗,两组均连续治疗3周后进行疗效评价。比较两组治疗前后心肾功能、血浆BNP、PRA、AngⅡ、ALD水平的变化情况。结果:治疗后,观察组总有效率为,显著高于对照组(P0.01);两组左心射血分数(LVEF)、表皮生长因子受体(eGFR)均较治疗前明显上升,SCr、BUN、血浆Cys C、BNP、PRA、AngⅡ、ALD水平均较治疗前明显降低(P0.01),且观察组LVEF、eGFR明显高于对照组,SCr、BUN、血浆Cys C、BNP、PRA、AngⅡ、ALD水平显著低于对照组(P0.01);观察组LVESD、LVEDD与治疗前比较明显降低(P0.01),而对照组治疗前后LVESD、LVEDD无明显变化(P0.05)。结论:益气温阳活血利水法治疗心肾综合征的临床疗效显著优于单用常规西医对症治疗,其可有效改善患者的心肾功能,降低患者的血浆BNP、PRA、AngⅡ、ALD水平。  相似文献   

3.
急性高原病通常分为急性高原反应(HAAR)、高原肺水肿(HAPE)和高原昏迷(HACC)三型。对其发病机理目前还存在着争议,为进一步探讨其发病机理,采用自身对比实验,观察了HAAR、HAPE各20名患者发病时及治愈后的血浆肾素(PRA)-血管紧张素(AⅡ)-醛固酮(ALD)系统及脑脊液变化。  相似文献   

4.
摘要 目的:探讨目标剂量螺内酯(20 mg/d)联合曲美他嗪对老年慢性心力衰竭(CHF)患者炎症因子、肾素-血管紧张素-醛固酮系统(RAAS)、及心率变异性的影响。方法:选取120例老年CHF患者,随机分为对照组和研究组,各60例,其中对照组给予曲美他嗪治疗,研究组给予曲美他嗪联合目标剂量螺内酯治疗,对比两组疗效、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]、RAAS指标 [肾素(PRA)、血管紧张素Ⅱ(AngⅡ)及醛固酮(ALD)]、心率变异性[24 h平均正常R-R间期标准差(SDNN),24 h连续5 min节段平均正常R-R间期标准差(SDANN),连续正常R-R间期差的均方根(rMSSD)]、心功能[左心室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]及安全性。结果:与对照组相比,研究组的总有效率更高(P<0.05)。治疗6个月后,两组hs-CRP、TNF-α、IL-6、LVESD、LVEDD、PRA、AngⅡ、ALD均较治疗前降低,且研究组上述指标低于对照组(P<0.05)。治疗6个月后,两组LVEF较治疗前升高,且研究组LVEF高于对照组(P<0.05)。治疗6个月后,研究组SDNN、SDANN、rMSSD均较治疗前升高,且研究组上述指标高于对照组(P<0.05)。两组不良反应发生率比较差异不明显(P>0.05)。结论:曲美他嗪联合目标剂量螺内酯治疗老年CHF患者疗效显著且安全性好,可明显改善患者的心功能、心率变异性,降低炎症因子水平,其可能是通过拮抗RAAS发挥作用。  相似文献   

5.
肾脏中肾素-血管紧张素系统的生理和病理生理作用   总被引:14,自引:0,他引:14  
肾脏中肾素-血管紧张素系统(RAS)在肾脏生理功能的调节中有重要作用.近年来,肾脏RAS的新成分及新作用机制不断被发现.转基因动物研究使肾脏血管紧张素Ⅱ(AngⅡ)在血压及水钠平衡调节中的作用进一步阐明;AngⅡ的非血流动力学作用已经确立;血管紧张素转换酶2(ACE2)及Ang 1~7对肾功能的调节作用也已得到认可.肾素/前肾素特异性受体、ACE的信号转导功能,以及AT1受体的转激活功能等,已成为肾脏生理科学研究的热点.这些研究对于人们认识肾脏局部RAS功能,探讨延缓慢性肾脏病的进展的治疗策略具有重要意义.  相似文献   

6.
目的:探讨重组脑钠肽对急性失代偿性心力衰竭患者炎症因子及肾素系统的影响。方法:选择2014年7月~2016年7月于我院就诊的急性失代偿性心力衰竭患者160例,80例对照组行硝普钠治疗,80例实验组行重组脑钠肽治疗,观察两组治疗前后肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、脑钠肽(BNP),醛固酮、血管紧张素Ⅱ、血浆肾素活性,血流动力学变化及心功能情况。结果:治疗前,实验组TNF-α、hs-CRP、IL-6、BNP低于对照组,差异有统计学意义(P0.05)。实验组醛固酮、血管紧张素Ⅱ、血浆肾素活性低于对照组,差异有统计学意义(P0.05)。实验组血流动力学低于对照组(P0.05)。实验组心功能较对照组改善更明显(P0.05);实验组副反应少于对照组(P0.05)。结论:急性失代偿性心力衰竭患者应用重组脑钠肽治疗可降低患者炎症因子,改善肾素系统。  相似文献   

7.
目的:研究高甲状腺素导致房颤与肾素-血管紧张素系统(RAS)相关的发病机制。方法:左旋甲状腺素经兔腹腔注射,制作甲亢源性房颤易患模型,同时厄贝沙坦经胃管灌胃,乳兔左心房肌细胞培养药物干预;检测房颤诱发率、左心房肌细胞凋亡情况,检测RAS相关的细胞因子,凋亡蛋白表达情况。结果:中途撤药组、厄贝沙坦组、对照组房颤诱发率低于持续给药组(P<0.05)。中途撤药组、持续给药组、厄贝沙坦组心肌细胞凋亡率、ACE m RNA相对表达量、ACE血浆浓度、表达量、AngⅡ血浆浓度、表达量均高于对照组,持续给药组高于中途撤药组、厄贝沙坦组(P<0.05)。中途撤药组、持续给药组、厄贝沙坦组PARP、caspase3相对表达量均高于对照组,持续给药组高于中途撤药组、厄贝沙坦组(P<0.05)。AngⅡ组药物干预后左心房肌细胞凋亡率高于对照组、甲状腺素组(P<0.05)。结论:高甲状腺素所致的房颤发病机制可能是间接过度激活RAS,循环、组织AngⅡ表达增高,后者诱导心房肌细胞凋亡,左心房发生电-解剖重构。  相似文献   

8.
目的:研究两种不同血浆肾素水平高血压大鼠心率变异的变化,进而探讨肾素。血管紧张素系统(RAS)影响心率变异(HRV)的机制。方法:制备两种高血压大鼠模型,采集其连续心电图数据。分析HRV的变化。并测定血浆血管紧张素Ⅱ(AngⅡ)的浓度。结果:肾性高血压大鼠血浆AngⅡ明显升高(P〈0.01),心率变异频域指标中TP(总功率谱)、VLF(极低频功率)、LF(低频功率)和HF(高频功率)明显降低,LF/HF(低高频比)升高;DOCA-盐型高血压大鼠血浆AngⅡ水平明显降低,TP、VLF、LF和HF也明显降低。LF/HF比值升高。结论:两种不同血浆肾素水平的高血压大鼠交感和迷走神经均受损,同时交感神经活性相对占优势;提示肾素血管紧张素系统是通过脑内RAS的激活而影响HRV,不是循环RAS的外周作用。  相似文献   

9.
目的:探讨PCI术前AMI伴左心衰竭患者死亡的高危因素.方法:回顾总结53例AMI伴左心衰患者,其中包括13例死亡病例.40例行PCI术的存活病例为对照组.将其临床特征及入院24小时内检测的血红蛋白(Hb)、血肌酐(Cr)、血氧饱和度(SaO2)、心肌坏死标志物,包括肌红蛋白(MYO),肌酸激酶同工酶(CK-MB),肌钙蛋白I(cTnI)和部分神经内分泌指标,包括肾素活性(PRA),血管紧张素Ⅱ(AngⅡ),醛固酮(ALD),肾上腺素(E).去甲肾上腺素(NE)进行对比研究.结果:死亡组在年龄、性别、Hb、Cr、SaO2、CK-MB、eTnI方面与存活组比较差别有显著性(P<0.05).结论:年龄偏大,多合并高血压病和糖尿病,早期发生低氧血症,以多支病变为特点的大面积心肌梗死患者易发生心功能不全,如同时合并肾功能不全、贫血的患者死亡风险高.  相似文献   

10.
肾素-血管紧张素-醛固酮系统起初被认为是较简单的神经体液调节机制之一。但是,这一想法随着RAAS阻滞剂:肾素阻滞剂、血管紧张素转换酶抑制剂(ACEI)、AT1受体拮抗剂及盐皮质激素受体拮抗剂的深入研究而受到挑战。因此,RAAS的组成、以上药物发挥作用的具体通路及副作用均得到重新定义。在RAAS阻滞剂的应用过程中,机体肾素水平升高,并刺激肾素原受体(即无活性的肾素前体,PRR),进而对机体造成不良影响。同理,在AT1受体拮抗剂的应用过程中,血浆血管紧张素II的水平升高,并与2型血管紧张素II(AT2)受体结合,进而对机体产生有利作用。此外,随着ACEI及ARB的应用,血管紧张素1-7水平升高,其与Mas受体结合,发挥心脏及肾脏保护的作用,还可通过刺激干细胞发挥组织修复作用。  相似文献   

11.
《Endocrine practice》2021,27(11):1072-1076
ObjectiveThere is a direct bidirectional link between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone system (RAAS), but few studies evaluated the RAAS in patients with primary hyperparathyroidism (PHPT), mainly biased from concomitant antihypertensive treatment.MethodsWe retrospectively evaluated a consecutive series of 130 normotensive patients with PHPT comparing aldosterone (ALD) levels and plasma renin activity (PRA) with the demographic, biochemical, or clinical features of PHPT.ResultsNo correlation was found between ALD and PRA, and the demographic, biochemical, and bone densitometry parameters in patients with PHPT without hypertension, with the exception of a negative correlation between age and serum PRA. Moreover, there was no significant correlation between PTH and ALD levels even in patients whose PTH level was >100 ng/L (P = .088).ConclusionIn our normotensive patients with PHPT, the ALD, PRA, and aldosterone/renin ratio were not correlated to PTH and calcium levels. In addition, they were neither related to PHPT clinical presentation nor renal function, vitamin D status, bone mass loss, or the presence of comorbidities such as diabetes and obesity. Further studies are needed to clarify the complex interplay between PTH and the RAAS in the modern PHPT presentation.  相似文献   

12.
目的:探讨缬沙坦氢氯噻嗪对高血压合并心力衰竭患者血管紧张素Ⅱ(Ang Ⅱ)、氨基末端脑钠尿肽前体(NT-ProBNP)及结缔组织生长因子(CTGF)的作用。方法:选择2016年3月到2019年3月我院收治的高血压合并心力衰竭患者113例进行研究,以随机数表法分为观察组(n=57)和对照组(n=56)。对照组给予贝那普利治疗,观察组在对照组的基础上采用缬沙坦氢氯噻嗪治疗。比较两组患者的临床疗效、Ang Ⅱ、NT-ProBNP及CTGF、左心室射血分数(LVEF)、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)、收缩压(SBP)、舒张压(DBP)水平变化情况及并发症发生情况。结果:治疗后,两组总有效率分别为92.98%、73.21%,差异显著;治疗前,两组Ang Ⅱ、NT-ProBNP及CTGF水平无显著差异(P>0.05);治疗后,两组Ang Ⅱ、NT-ProBNP及CTGF水平均显著改善,且观察组均低于对照组(P<0.05);治疗前,两组心功能水平无显著差异(P>0.05);治疗后,两组心功能水平均显著改善,且观察组LVEF高于对照组,LVESd、LVEDd低于对照组(P<0.05);治疗前,两组血压水平无显著差异(P>0.05);治疗后,两组血压水平均显著改善,且观察组SBP、DBP水平显著低于对照组,差异显著(P<0.05);两组并发症总发生率分别为7.02%、10.71%,差异无显著差异(P>0.05)。结论:在高血压合并心力衰竭患者中应用缬沙坦氢氯噻嗪辅助治疗效果显著,可有效改善患者心功能、Ang Ⅱ、NT-ProBNP及CTGF水平。  相似文献   

13.
Losartan, a recently developed nonpeptide angiotensin II (Ang II) receptor antagonist, was administered orally to 10-week-old spontaneously hypertensive rats (SHR) for 2 weeks. Cardiac weight and tissue Ang II, as well as plasma renin activity (PRA) and Ang II, were determined. Treatment with Losartan (10 mg/kg per day) lowered blood pressure markedly. Losartan reduced significantly the left ventricular weight by 11% compared with control rats. The left ventricular Ang II content was lowered by Losartan (18.6 +/- 0.9 pg/tissue; 21.9 +/- 0.9 pg/tissue, control, p less than 0.05), whereas PRA and plasma Ang II concentration were increased by the treatment. With the control and Losartan-treated animals, there was a significant positive correlation between the left ventricular weight and the tissue Ang II content (r = 0.563, p less than 0.05). These results provide evidence that cardiac tissue Ang II, rather than circulating Ang II, plays an important role in the pathophysiology of left ventricular hypertrophy of this animal model of human hypertension.  相似文献   

14.
Previous studies demonstrated elevated plasma leptin and angiotensinogen (PRA) levels in essential hypertension. However, a few studies investigated the relationship between leptin and angiotensinogen levels in both lean and overweight/ obese hypertensives. The aim of the present study was therefore to examine the relationship between blood pressure, leptin and plasma renin activity in normotensives and in both lean and overweight/obese patients with essential hypertension. Two groups of subjects who were carefully matched for age, gender, waist:hip ratio and body mass index (BMI) were studied: 28 normotensives (NT) (age: 40.1+/-9.1 years old, BMI: 28.1+/-3.6 kg/m2, male/female: 18/10) and 33 newly diagnosed mild to moderate essential hypertensives (EHT) (age: 38.9+/-10 years old, BMI: 27.9+/-4.8 kg/m2, male/female: 22/11). No significant differences in age, gender, waist:hip ratio, fasting blood glucose and BMI were detected between EHT and NT groups. However, systolic and diastolic pressures, mean arterial blood pressures, plasma leptin levels and PRA were significantly higher in EHT group than in NT group (P = 0.001). Plasma leptin levels were strongly correlated with BMI in EHT (r=0.67, P = 0.001) and NT groups (r=0.44, P = 0.001). Plasma leptin levels were correlated with plasma PRA levels in both EHT and NT groups (r = 0.66 and r = 0.44; both P < 0.05, respectively). There was no correlation between leptin or PRA and systolic, diastolic pressures, or mean arterial blood pressures. Furthermore, the patients were divided as lean (n=16) and overweight/obese (n = 17) and compared with BMI-matched controls. In both subgroups, plasma leptin and PRA levels were also higher than those of controls. Our results showed that elevated plasma leptin and PRA are associated with hypertension in both lean and overweight/obese hypertensives. Moreover, plasma leptin was significantly correlated with plasma angiotensinogen levels. These findings suggest that adipose mass is an important determinant of blood pressure, although the mechanism is not clear.  相似文献   

15.
Cerebrospinal fluid (CSF) catecholamines were measured in normotensive patients and in patients with mild to moderate essential hypertension. CSF-norepinephrine (NE) concentrations were 50% lower in the normotensive individuals (127 ± 28 vs. 240 ± 23 pg/m1) (P<0.01). In hypertensive patients, CSF-NE was inversely related to age (r =-0.68; P<0.01) and directly related to plasma NE (r = 0.61; P<0.05). Clonidine (450 mcg/day for 2 weeks) significantly reduced CSF-NE (?40%) in hypertensive patients. In addition, it decreased blood pressure, plasma and urinary NE. Urinary VMA was not affected by clonidine. No correlation was observed between clonidine effects on BP and on plasma or CSF catecholamines. This study indicates that patients with essential hypertension have elevated levels of CSF-NE which are reduced after treatment with clonidine. The elevation of CSF-NE suggests that central (spinal?) noradrenergic activity may be increased in patients with mild to moderate essential hypertension, and that can be reduced by treatment with clonidine.  相似文献   

16.
To determine circulating angiotensin-(1-7) [Ang-(1,7)] levels in rats with different angiotensin converting enzyme (ACE) genotypes and to evaluate the effect of hypertension on levels of this heptapeptide, plasma levels of angiotensin II (Ang II) and Ang-(1-7) were determined by HPLC and radioimmunoassay in (a) normotensive F0 and F2 homozygous Brown Norway (BN; with high ACE) or Lewis (with low ACE) rats and (b) in hypertensive F2 homozygous male rats (Goldblatt model). Genotypes were characterized by PCR and plasma ACE activity measured by fluorimetry. Plasma ACE activity was 2-fold higher (p < 0.05) in homozygous BN compared to homozygous Lewis groups. In the Goldblatt groups, a similar degree of hypertension and left ventricular hypertrophy was observed in rats with both genotypes. Plasma Ang II levels were between 300-400% higher (p < 0.05) in the BN than in the Lewis rats, without increment in the hypertensive animals. Plasma Ang-(1-7) levels were 75-87% lower in the BN rats (p < 0.05) and they were significantly higher (p < 0.05) in the hypertensive rats from both genotypes. Plasma levels of Ang II and Ang-(1-7) levels were inversely correlated in the normotensive rats (r = -0.64; p < 0.001), but not in the hypertensive animals. We conclude that there is an inverse relationship between circulating levels of Ang II and Ang-(1-7) in rats determined by the ACE gene polymorphism. This inverse relation is due to genetically determined higher ACE activity. Besides, plasma levels of Ang-(1-7) increase in renovascular hypertension.  相似文献   

17.
目的:探讨内皮型一氧化氮合酶(eNOS)基因894G/T多态性与原发性高血压(EH)合并脑梗塞(CI)的关系。方法:应用聚合酶链反应限制性片段长度多态性方法检测湖北地区汉族74例健康者(NT组)、103例原发性高血压无合并症者(EH组)及70例原发性高血压合并脑梗塞者(EH-CI组)的eNOS基因型;生化技术测定其血脂、一氧化氮代谢物(NOM)水平。结果:EH组及EH-CI组患者的T等位基因频率分别为0.224和0.321,均显著高于NT组(P<0.05);且两者之间的T等位基因频率差异显著性(P<0.05);EH-CI组中,GT+TT基因型者的舒张压显著高于GG基因型者(P<0.05),而NOM显著低于GG基因型者。结论:eNOS基因894位G/T多态性可能与汉族高血压病患者伴脑梗塞有关,该位点多态性可能使T等位基因携带者NOM减少,进而参与EH-CI发病。  相似文献   

18.
The goals of our present study were to measure plasma homocysteine levels and determine their association with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (C677T and A1298C) in essential hypertensive subjects. Plasma total homocysteine and folic acid levels were measured in essential hypertensive patients (n = 153) before and after oral supplementation with either 5 mg folic acid tablet/day or 5 mg placebo/day for 4 weeks and compared with age and sex matched normotensive controls (n = 133). MTHFR gene polymorphisms (C677T and A1298C) were studied by restriction fragment length polymorphism and correlated with plasma homocysteine levels. Homocysteine levels were significantly higher in hypertensive patients as compared to controls and showed a negative correlation with plasma folate levels. Folic acid supplementation (5 mg/day) for 4 weeks resulted in a significant decrease in plasma homocysteine concentrations in these patients. Patients carrying MTHFR 677T allele (OR = 1.90; 95%CI: 1.14–3.19) or MTHFR 1298C (OR = 2.6, 95%CI: 1.55–4.40) allele were at increased risk of hypertension. The frequency of co-occurrence of MTHFR 677 CT/1298 CC genotypes was significantly higher in the patients compared to controls (P < 0.05) and was associated with increased risk of hypertension (OR = 3.54, 95%CI: 0.37–4.30). Subjects with MTHFR 1298 CC genotype had significantly higher homocysteine levels compared to those with MTHFR 1298 AA genotype (P < 0.05). Our results indicate that MTHFR 677T and 1298C alleles and co-occurrence of MTHFR 677 CT/MTHFR 1298 CC genotypes are associated with increased risk of hypertension and MTHFR 1298 CC genotype is associated with higher homocysteine levels in our subjects.  相似文献   

19.
Thirty mildly hypertensive patients and 27 patients with severe essential hypertension and high levels of aldosterone were selected for a study of the relationship between plasma aldosterone and magnesium in essential arterial hypertension; levels of calcium and potassium were also studied. Thirty-six individuals were used as a control group. Our findings indicate that as plasma aldosterone levels increase, serum magnesium levels decrease correspondingly: in mild hypertensives with low levels of plasma aldosterone p less than 0.05 and in the most severely hypertensive patients with high levels of plasma aldosterone p less than 0.001. In this latter group we also found an inverse correlation between serum magnesium and systolic arterial pressure (p less than 0.001) and diastolic pressure (p less than 0.01). In these patients a significant increase in urinary excretion of magnesium was found, with levels 3 times higher than in the control group. These findings suggest a close relationship between changes in plasma aldosterone and magnesium. Possibly the aldosterone contributes through this mechanism to maintaining the hypertensive state in essential arterial hypertension. This action is exercised directly through the kidney, leading to a small but constant urinary loss of magnesium. This in turn leads to a chronic depletion of magnesium in hypertensives who have high levels of plasma renin activity and highly elevated plasma aldosterone.  相似文献   

20.

Background

The renin-angiotensin aldosterone system (RAAS) plays an important role in regulating the blood pressure and the genetic polymorphisms of RAAS genes has been extensively studied in relation to the cardiovascular diseases in various populations with conflicting results. The aim of this study was to determine the association of five genetic polymorphisms (A6G and A20C of angiotensinogen (AGT), MboI of renin, Gly460Trp of aldosterone synthase and Lys173Arg of adducin) of RAAS genes in Malaysian essential hypertensive and type 2 diabetic subjects.

Methods

RAAS gene polymorphisms were determined using mutagenically separated PCR and PCR-RFLP method in a total of 270 subjects consisting of 70 hypertensive subjects without type 2 diabetes mellitus (T2DM), 60 T2DM, 65 hypertensive subjects with T2DM and 75 control subjects.

Results

There was significant difference found in age, body mass index, systolic/diastolic blood pressure, fasting plasma glucose and high density lipoprotein cholesterol levels between the hypertensive subjects with or without T2DM and control subjects. No statistically significant differences between groups were found in the allele frequency and genotype distribution for A20C variant of AGT gene, MboI of renin, Gly460Trp of aldosterone and Lys173Arg of adducin (p > 0.05). However, the results for A6G of AGT gene revealed significant differences in allele and genotype frequencies in essential hypertension with or without T2DM (p < 0.001).

Conclusion

Among the five polymorphisms of RAAS genes only A6G variant of AGT gene was significantly associated in Malaysian essential hypertensive and type 2 diabetic subjects. Therefore, A6G polymorphism of the AGT gene could be a potential genetic marker for increased susceptibility to essential hypertension with or without T2DMin Malaysian subjects.  相似文献   

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