摘要
背景:目前对于高血压凝血和纤溶系统的改变存在着争议,而凝血和纤溶系统在高血压血栓栓塞性和/或出血性并发症的进程中具有关键性作用,因此,检测高血压患者的凝血和纤溶状态,并以此为依据合理选用能改善其凝血和纤溶状态的抗高血压药以及据此提出合理的康复介入方案,具有不容忽视的临床价值。设计:随机对照的实验研究。目的:探讨厄贝沙坦和咪达普利在降压的同时,对早期雄性自发性高血压大鼠(spontaneouslyhypertensiverats,SHR)血浆凝血酶原时间、纤维蛋白原含量、组织型纤溶酶原激活物活性(tissue-typeplasminogenacti-vatoractivity,t-PA:A)、纤溶酶原激活物抑制剂活性(plasminogenactiva-torinhibitoractivity,PAI:A)和α2-纤溶酶抑制物活性(α2plasminin-hibitoractivity,α2-PI:A)的影响。地点、材料和干预:本实验在武汉大学医院检验中心进行。15周龄雄性SHR30只按随机数字表法分为3组,咪达普利组给予含咪达普利的水3mg/(kg·d);厄贝沙坦组给含厄贝沙坦的水50mg/(kg·d);SHR对照组和同龄雄性WistarKyoto(WKY)大鼠(正常血压对照组)10只以等量蒸馏水代替;采用一期法检测血浆凝血酶原时间,采用凝血酶法检测血浆纤维蛋白原含量,采用发色底物法检测血浆t-PA:A,PAI:A和α2-PI:A。
BACKGROUND:Coagulative and fibrinolytic system is commonly recommended for early male spontaneously hypertensive rat(SHR),however,its effects have not been demonstrated in randomized controlled studies. OBJECTIVE:To assess the effects of irbesartan and imidarpril on plasma prothrombin time,fibrinogen,tissue type plasminogen activator activity(t PA:A),plasminogen activator inhibitor activity(PAI:A) and α 2 plasmin inhibitor activity(α 2 PI:A) in early male SHR. DESIGN:Randomized controlled study. INTERVENTIONS:Thirty pieces of 15 week old male SHRs were divided into three groups(n=10,each),imidapril grou[(3 mg/(kg· d)],irbesartan group[50 mg/(kg· d)] and SHR control group(equal volume of distilled water) were adminstered by drinking respectively for three months.Ten age matched male Wistar Kyoto(WKY) rats(healthy control group) were also received equal volume of distilled water by drinking.Plasma prothrombin time were determined with one step means,Plasma fibrinogen were determined by means of thrombin and Plasma t PA:A,PAI:A and α 2 PI:A were determined by means of Color Substrate. MAIN OUTCOME MEASURES:The outcome of interventions by irbesartan and imidarpril compared with age matched male WKY rats. RESULTS:As compared to WKY group,SHR group had singnificantly higher fibrinogen(P< 0.01) and t PA:A(P< 0.05) but had singnificantly lower α 2 PI:A(P< 0.01),prothrombin time and PAI:A had no significant effact.As compared to SHR group,not only the blood pressure and fibrinogen in imidapril and irbesartan group were significantly decreased(P< 0.01) but also α 2 PI:A were significantly increased(P< 0.01) After three months treatment.In addition,imidapril had higher α 2 PI:A(but P >0.05) than irbesartan group. CONCLUSION:① Intravascular coagulation and fibrinolysis in early male SHRs is concurrent,which indicate that there are chronic disseminated intravscular coagulation(DIC) in early male SHRs,therefore,who are in danger of thromboembolism and/or hemorrhage.② The interventions of imidapril and irbesartan could improve the impaired coagulative and fibrinolytic system.Thus may reduce the complication of hemorrhage and/or thromboembolism.
出处
《中国临床康复》
CSCD
2004年第6期1165-1167,共3页
Chinese Journal of Clinical Rehabilitation
