To compare the pharmacokinetics properties of enalapril-felodipine sustained-release tablet with enalapril and felodipine in the two reference formulations in Chinese healthy volunteers, the study was designed to a ra...To compare the pharmacokinetics properties of enalapril-felodipine sustained-release tablet with enalapril and felodipine in the two reference formulations in Chinese healthy volunteers, the study was designed to a randomized, open label, crossover and two treatment pharmacokinetic study using enalapril-felodipine sustatined-release tablet as the test formulation. A total of 12 individuals were randomly assigned to 2 gorups （6 individuals in each group）. The wash-out period was 14 d. Compared with the reference formulations, felodipine in the sustained-release tablet showed significantly sustained-release characteristics, while the pharmacokinetics processes of enalapril and its active metabolite enalaprilat were basically similar in Chinese healthy volunteers.展开更多
Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to en...Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to enalapril among patients with essential hypertension.Methods:A total of 130 patients with mild-to-moderate essential hypertension were enrolled and enalapril was orally administered at a dose of 10 mg/d for eight weeks.Plasma Hcy levels were measured by denaturing high-performance liquid chromatography(DHPLC) at baseline and after eight weeks of treatment.Genotyping of MTHFR C677T polymorphism was performed by TaqMan probe technique.Results:Compared with baseline,plasma Hcy levels did not change significantly after eight weeks(P=0.81).Stratified by baseline Hcy levels,a significant increase in plasma Hcy levels(P=0.02) among those with Hcy <10 μmol/L was observed,in contrast to no significant changes in plasma Hcy levels(P=0.54) among those with Hcy ≥10 μmol/L.No significant association was observed between MTHFR C677T polymorphism and changes in Hcy levels in response to enalapril.Conclusions:Enalapril may cause an increase in plasma Hcy levels among the hypertensives with low baseline Hcy levels.There was no significant association between MTHFR C677T genotypes and changes in Hcy levels in response to enalapril among subjects with essential hypertension.展开更多
Objectives. To compare the effects of losartan, enalapril and their combination in the prevention ofleft ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat. Methods. AMI model was induced...Objectives. To compare the effects of losartan, enalapril and their combination in the prevention ofleft ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat. Methods. AMI model was induced in female SD rats by ligating left coronary artery. Forty-eight hours after the procedure, 83 surviving rats were randomized into one of the following 4 groups: 1 ) AMI control group (n =19), 2) losartan group (n= 22, 3 mg @ kg - 1 @ d - 1 ), 3 ) enalapril group (n = 20, 1 mg @ kg - 1 @ d - 1 ), 4) losartan - enalapril combinative group (n = 22, 3 and 1 mg @ kg- 1 @ d - 1 respectively). 5 ) sham-operated group ( n =10) and 6) normal rats group (n = 10) were selected randomly to serve as non-infarction controls. Losartan and enalapril were delivered by direct gastric gavage. After 4 weeks of medical therapy, hemodynamic studies were performed in each group, then the rat hearts were fixed with 10% formalin and pathologic analysis on them was performed. Complete experimental data was obtained in 56 rats, comprising 1 ) AMI controls (n = 11 ), 2) losartan group (n = 10), 3 ) enalapril group (n = 10), 4) the combination of losartan and enalapril group (n = 11 ),5) sham - operated group (n = 6) and 6) normal controls (n=8). Results. There were no significant differences among the 4 AMI groups in MI size (41.7% ～ 43.4%, all P＞ 0.05). Compared with sham group, the left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), long and short axis length (L and D), as well as LV absolute and relative weight (LVAW and LVRW)in AMI group were all significantly increased ( P ＜0.05 ～ 0. 001 ); whereas the maximum left ventricular pressure rising and droping rates ( + dp/dt) and their corrected values by LV systolic pressure ( + dp/dt/LVSP)were significantly reduced (all P ＜0.001 ), indicating LVRM occurred and LV systolic and diastolic function impaired after AMI. Compared with AMI group , LVEDP, LVV, LVAW and LVRW were all significantly decreased (P ＜0.05～0.001 ); while + dp/dt/LVSP were significantly enhanced in all 3 treatment groups (P ＜0.05～0.001 ) except -dp/dt/LVSP in losartan group (P＞ 0. 05 ). There were no significant differences in the above indices among the 3 treatment groups (all P＞ 0.05). Conclusion. Both losartan and enalapril can prevent from LVRM after AMI in the rat and improve LV function with equivalent effects. There seems no additive effect when the 2 drugs are used in combination.展开更多
Objective To investigate the role of transforming growth factor-β1 （TGF-β1）, Smad2/3 and Smad7 expressions in carotid artery remodeling in renovascular hypertensive rats, and also the therapeutic effect of Enalapr...Objective To investigate the role of transforming growth factor-β1 （TGF-β1）, Smad2/3 and Smad7 expressions in carotid artery remodeling in renovascular hypertensive rats, and also the therapeutic effect of Enalapril and Amlodipine. Methods The renovascular hypertensive rat （RHR） models with ＂two-kidney and one-clip＂ were established, including model group （n = 6）, sham-operated group （n = 6）, Enalapril group （10 mg/kg per day, n = 6）, Amlodipine group （5 mg/kg per day, n = 6） and combination group （Amlodipine 2.5 mg/kg per day ＋ Enalapril 5mg/kg per day, n = 6）. The medication were continuous administrated for six weeks. Carotid artery morphological and structural changes in the media were observed by HE staining, Masson staining and immuno histochemical staining. Media thickness （MT）, MT and lumen diameter ratio （MT/LD）, and the expression levels of media a-smooth muscle actin （α-actin）, proliferating cell nuclear antigen （PCNA）, TGF-β1, phosphorylated Smad2/3 （p-Smad2/3） and Smad7 in carotid arteries were measured. Results The media of carotid arteries in RHR model group was significantly thickened, the volume of smooth muscle cell was increased, and the array was in disorder; MT, MT/LD, the proliferation index of smooth muscle cell and collagen fiber area percentage of carotid arteries in the model group were significantly higher than those in the sham-operated group （P 〈 0.01）. Compared to sham-operated group, the model group had significantly higher expressions of TGF-β1 and p-Smad2/3 （P 〈 0.05） and lower Smad7 expression. Both Enalapril and Amlodipine improved smooth muscle hypertrophy and collagen deposition, reduced RHR carotid MT, MT/LD, proliferation index of smooth muscle cell, collagen fiber area percentage and the expressions of TGF-β1 and p-Smad2/3 （P 〈 0.05）, increased Smad7 expression （P 〈 0.05）. Moreover, the combination treatment of Enalapril and Amlodipine had significantly better effects than single Amlodipine group （P 〈 0.05）, but not single Enalapril group. Conclusions TGF-β1/Smads pathway may participate in the mechanism of carotid artery remodeling in RHR; the role of Amlodipine and Enalapril in inversing carotid artery remodeling may be related to the change of TGF-β1/Smads pathway, the combination treatment of Amlodipine and Enalapril had better effects than single administration of Amlodipine.展开更多
AIM: To investigate the protective effect of paricalcitol and enalapril on renal inflammation and oxidative stress in Apo E-knock out mice. METHODS: Animals treated for 4 mo as group(1) Apo E-knock out plus vehicle, g...AIM: To investigate the protective effect of paricalcitol and enalapril on renal inflammation and oxidative stress in Apo E-knock out mice. METHODS: Animals treated for 4 mo as group(1) Apo E-knock out plus vehicle, group(2) Apo E-knock out plus paricalcitol(200 ng thrice a week),(3) Apo Eknock out plus enalapril(30 mg/L),(4) Apo E-knock out plus paricalcitol plus enalapril and(5) normal. Blood pressure(BP) was recorded using tail cuff method. The kidneys were isolated for biochemical assays using spectrophotometer and Western blot analyses. RESULTS: Apo E-deficient mice developed high BP(127 ± 3 mm Hg) and it was ameliorated by enalapril and enalapril plus paricalcitol treatments but not with paricalcitol alone. Renal malondialdehyde concentrations, p22 phox, manganese-superoxide dismutase, inducible nitric oxide synthase(NOS), monocyte chemoattractant protein-1, tumor necrosis factor-alpha and transforming growth factor-β1 levels significantly elevated but reduced glutathione, Cu Zn-SOD and e NOS levels significantly depleted in Apo E-knock out animals compared to normal. Administration of paricalcitol, enalapril and combined together ameliorated the renal inflammation and oxidative stress in Apo E-knock out animals. CONCLUSION: Paricalcitol and enalapril combo treatment ameliorates renal inflammation as well as oxidative stress in atherosclerotic animals.展开更多
Objecrive:To explore the effect of enalapril combined with hydroch1orothiazide and indapamide on hypertension and heart failure.Methods:8o patients with hypertension and heart failure admitted to our hospitail from Ja...Objecrive:To explore the effect of enalapril combined with hydroch1orothiazide and indapamide on hypertension and heart failure.Methods:8o patients with hypertension and heart failure admitted to our hospitail from January 2019 to January 2020 were selected as the research subjects,and they were divided into two groups with random number table method,40 cases each.The control group was given conventional treatment regimens,including enalapril and hydroch1orothiazide;the observation group replaced hydrochlorothiazide with indapamide based on the above therapies.The efficacy and systolic blood pressure,diastolic blood pressure and left heart ejection fraction(LVEF)of the two groups were compared.Results:After treatment,the effective rate of the observation group was 92.50%(37/40)higher than that of the control group 75.00%(30/40).The systolic and diastolic blood pressure were lower than those of the control group,and the LVEF was higher than that of the control group.The difference was statistically significant(P<0.05).Conclusion:Enalapril combined with indapamide is effective in the treatment of hypertension with heart failure,which can help 1ower blood pressure,reduce heart 1oad,increase cardiac output,reverse ventricular remodeling,and delay disease progression.展开更多
Objective The present study was designed to examine whether the renin-angiotensin system would be implicated in the development of hepatic fibrosis induced by CCI4. The effects of enalapril on the ex-pression of plate...Objective The present study was designed to examine whether the renin-angiotensin system would be implicated in the development of hepatic fibrosis induced by CCI4. The effects of enalapril on the ex-pression of platelet derived growth factor receptor (PDGFR) in liver tissue were also investigated. Methods 50 Sprague-Dawley rats were randomly divided into S groups (control group, model group, and 3 enalapril treated groups). Except rats of the model group, all rats received subcutanous injection of 40% CC14 (every 3d for 6 weeks). Rats of enalapril treated groups were given enalapril (10mg/kg, 5mg/kg, 2.5mg/kg per day, orally)for 6 weeks before they were killed. Serum levels of hyaluronic acid (HA) and laminin (LW) were de-termined by radioimmunoassay techniques. Van Gieson collagen staining was used to evaluate the extracellular matrix of the liver. The expressions of PDGFR and a-smooth muscle actin (a-SMA) were confirmed by im-munohistochemical methods. Results Compared with those in the model gr oup, it was found in enalapril treated groups: (1) serum levels of collagen type 1V and LN were significantly reduced (P< 0. 01); (2) the pro-gression of fibrosis was delayed (P < 0. 01); (3) the expressions of PDGFR and a-SMA were decreased. Conclusion The renin-angiotensin system was involved in the development of hepatic fibrosis induced by Cd4. Angiotensin-converting enzyme (ACE) inhibitor and enalapril could slow down the rate of hepatic fibrosis. This effect might be due to the ability of this drug in suppressing the expression of PDGFR of liver tissue.展开更多
Background The incidence of leg edema caused by calcium channel blockers（CCB） is so high, some studies tried combination with angiotension converting enzyme inhibitors（ACEI） or diuretics to overcome this problem.H...Background The incidence of leg edema caused by calcium channel blockers（CCB） is so high, some studies tried combination with angiotension converting enzyme inhibitors（ACEI） or diuretics to overcome this problem.However, there is no comparison about which is better to improve edema at present. Methods This study was designed as a single-center, prospective, randomized, double-blind, parallel-group, clinical trial. 224 hypertensive patients with leg edema after 4 weeks since taking levamlodipine were enrolled, and they were randomly divided into levamlodipine ＋ furosemide（CD） group and levamlodipine ＋ enalapril（CA） group for another 4 weeks. Ankle circumference（AC）, edema score（ES）, blood pressure（BP） and cure rate of leg edema were evaluated. Results Altogether 179 patients（89 in CD group and 90 in CA group） completed the 4-week treatment. After the 4-week therapy with furosemide or enalapril, most subjects were free of edema in either group（96.51% vs.96.67%, P 〉 0.05）. Only 4 in CD group and 3 in CA group had mild edema. Enalapril was more effective than furosemide to reduce AC（10.92 ± 1.84 mm vs. 12.97 ± 2.46 mm, P 〈 0.05）. But for ES, there was no significant difference. And there were no significant differences in antihypertensive effect between them. Uric acid（UA）was increased significantly in CD group（10.70 ± 18.48 μmol/L vs. 0.22 ± 28.13 μmol/L, P 〈 0.05）. Conclusion Enalapril is more effective than furosemide in attenuating lower extremity edema caused by levamlodipine in essential hypertensive population, with equal antihypertensive efficacy and less uric acid increasing.展开更多
The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were ...The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were enrolled from December 2016 to November 2017.They were randomly divided into two groups,33 patients in each group.Patients in the experimental group received nifedipine.In combination with enalapril,patients enrolled in the control group received nifedipine monotherapy.Compared with the control group,the total effective rate,serum nitric oxide(NO)after treatment,C-reactive protein(CRP)after treatment,homocysteine(HCY)after treatment,and blood pressure after treatment were significantly improved(P<0.05).There were no significant differences in serum NO,pre-treatment CRP,pre-treatment HCY,pre-treatment blood pressure,and adverse reactions during treatment between the two groups(P>0.05).The elderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.展开更多
基金National Natural Science Foundation of China(Grant No.81102499)supported by Hunan Science and Technology Project(Grant No.2011SK3261,Changsha,China)
文摘To compare the pharmacokinetics properties of enalapril-felodipine sustained-release tablet with enalapril and felodipine in the two reference formulations in Chinese healthy volunteers, the study was designed to a randomized, open label, crossover and two treatment pharmacokinetic study using enalapril-felodipine sustatined-release tablet as the test formulation. A total of 12 individuals were randomly assigned to 2 gorups （6 individuals in each group）. The wash-out period was 14 d. Compared with the reference formulations, felodipine in the sustained-release tablet showed significantly sustained-release characteristics, while the pharmacokinetics processes of enalapril and its active metabolite enalaprilat were basically similar in Chinese healthy volunteers.
文摘Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to enalapril among patients with essential hypertension.Methods:A total of 130 patients with mild-to-moderate essential hypertension were enrolled and enalapril was orally administered at a dose of 10 mg/d for eight weeks.Plasma Hcy levels were measured by denaturing high-performance liquid chromatography(DHPLC) at baseline and after eight weeks of treatment.Genotyping of MTHFR C677T polymorphism was performed by TaqMan probe technique.Results:Compared with baseline,plasma Hcy levels did not change significantly after eight weeks(P=0.81).Stratified by baseline Hcy levels,a significant increase in plasma Hcy levels(P=0.02) among those with Hcy <10 μmol/L was observed,in contrast to no significant changes in plasma Hcy levels(P=0.54) among those with Hcy ≥10 μmol/L.No significant association was observed between MTHFR C677T polymorphism and changes in Hcy levels in response to enalapril.Conclusions:Enalapril may cause an increase in plasma Hcy levels among the hypertensives with low baseline Hcy levels.There was no significant association between MTHFR C677T genotypes and changes in Hcy levels in response to enalapril among subjects with essential hypertension.
文摘Objectives. To compare the effects of losartan, enalapril and their combination in the prevention ofleft ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat. Methods. AMI model was induced in female SD rats by ligating left coronary artery. Forty-eight hours after the procedure, 83 surviving rats were randomized into one of the following 4 groups: 1 ) AMI control group (n =19), 2) losartan group (n= 22, 3 mg @ kg - 1 @ d - 1 ), 3 ) enalapril group (n = 20, 1 mg @ kg - 1 @ d - 1 ), 4) losartan - enalapril combinative group (n = 22, 3 and 1 mg @ kg- 1 @ d - 1 respectively). 5 ) sham-operated group ( n =10) and 6) normal rats group (n = 10) were selected randomly to serve as non-infarction controls. Losartan and enalapril were delivered by direct gastric gavage. After 4 weeks of medical therapy, hemodynamic studies were performed in each group, then the rat hearts were fixed with 10% formalin and pathologic analysis on them was performed. Complete experimental data was obtained in 56 rats, comprising 1 ) AMI controls (n = 11 ), 2) losartan group (n = 10), 3 ) enalapril group (n = 10), 4) the combination of losartan and enalapril group (n = 11 ),5) sham - operated group (n = 6) and 6) normal controls (n=8). Results. There were no significant differences among the 4 AMI groups in MI size (41.7% ～ 43.4%, all P＞ 0.05). Compared with sham group, the left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), long and short axis length (L and D), as well as LV absolute and relative weight (LVAW and LVRW)in AMI group were all significantly increased ( P ＜0.05 ～ 0. 001 ); whereas the maximum left ventricular pressure rising and droping rates ( + dp/dt) and their corrected values by LV systolic pressure ( + dp/dt/LVSP)were significantly reduced (all P ＜0.001 ), indicating LVRM occurred and LV systolic and diastolic function impaired after AMI. Compared with AMI group , LVEDP, LVV, LVAW and LVRW were all significantly decreased (P ＜0.05～0.001 ); while + dp/dt/LVSP were significantly enhanced in all 3 treatment groups (P ＜0.05～0.001 ) except -dp/dt/LVSP in losartan group (P＞ 0. 05 ). There were no significant differences in the above indices among the 3 treatment groups (all P＞ 0.05). Conclusion. Both losartan and enalapril can prevent from LVRM after AMI in the rat and improve LV function with equivalent effects. There seems no additive effect when the 2 drugs are used in combination.
文摘Objective To investigate the role of transforming growth factor-β1 （TGF-β1）, Smad2/3 and Smad7 expressions in carotid artery remodeling in renovascular hypertensive rats, and also the therapeutic effect of Enalapril and Amlodipine. Methods The renovascular hypertensive rat （RHR） models with ＂two-kidney and one-clip＂ were established, including model group （n = 6）, sham-operated group （n = 6）, Enalapril group （10 mg/kg per day, n = 6）, Amlodipine group （5 mg/kg per day, n = 6） and combination group （Amlodipine 2.5 mg/kg per day ＋ Enalapril 5mg/kg per day, n = 6）. The medication were continuous administrated for six weeks. Carotid artery morphological and structural changes in the media were observed by HE staining, Masson staining and immuno histochemical staining. Media thickness （MT）, MT and lumen diameter ratio （MT/LD）, and the expression levels of media a-smooth muscle actin （α-actin）, proliferating cell nuclear antigen （PCNA）, TGF-β1, phosphorylated Smad2/3 （p-Smad2/3） and Smad7 in carotid arteries were measured. Results The media of carotid arteries in RHR model group was significantly thickened, the volume of smooth muscle cell was increased, and the array was in disorder; MT, MT/LD, the proliferation index of smooth muscle cell and collagen fiber area percentage of carotid arteries in the model group were significantly higher than those in the sham-operated group （P 〈 0.01）. Compared to sham-operated group, the model group had significantly higher expressions of TGF-β1 and p-Smad2/3 （P 〈 0.05） and lower Smad7 expression. Both Enalapril and Amlodipine improved smooth muscle hypertrophy and collagen deposition, reduced RHR carotid MT, MT/LD, proliferation index of smooth muscle cell, collagen fiber area percentage and the expressions of TGF-β1 and p-Smad2/3 （P 〈 0.05）, increased Smad7 expression （P 〈 0.05）. Moreover, the combination treatment of Enalapril and Amlodipine had significantly better effects than single Amlodipine group （P 〈 0.05）, but not single Enalapril group. Conclusions TGF-β1/Smads pathway may participate in the mechanism of carotid artery remodeling in RHR; the role of Amlodipine and Enalapril in inversing carotid artery remodeling may be related to the change of TGF-β1/Smads pathway, the combination treatment of Amlodipine and Enalapril had better effects than single administration of Amlodipine.
基金Supported by A research grant from Abbott Pharmaceutical,United States
文摘AIM: To investigate the protective effect of paricalcitol and enalapril on renal inflammation and oxidative stress in Apo E-knock out mice. METHODS: Animals treated for 4 mo as group(1) Apo E-knock out plus vehicle, group(2) Apo E-knock out plus paricalcitol(200 ng thrice a week),(3) Apo Eknock out plus enalapril(30 mg/L),(4) Apo E-knock out plus paricalcitol plus enalapril and(5) normal. Blood pressure(BP) was recorded using tail cuff method. The kidneys were isolated for biochemical assays using spectrophotometer and Western blot analyses. RESULTS: Apo E-deficient mice developed high BP(127 ± 3 mm Hg) and it was ameliorated by enalapril and enalapril plus paricalcitol treatments but not with paricalcitol alone. Renal malondialdehyde concentrations, p22 phox, manganese-superoxide dismutase, inducible nitric oxide synthase(NOS), monocyte chemoattractant protein-1, tumor necrosis factor-alpha and transforming growth factor-β1 levels significantly elevated but reduced glutathione, Cu Zn-SOD and e NOS levels significantly depleted in Apo E-knock out animals compared to normal. Administration of paricalcitol, enalapril and combined together ameliorated the renal inflammation and oxidative stress in Apo E-knock out animals. CONCLUSION: Paricalcitol and enalapril combo treatment ameliorates renal inflammation as well as oxidative stress in atherosclerotic animals.
文摘Objecrive:To explore the effect of enalapril combined with hydroch1orothiazide and indapamide on hypertension and heart failure.Methods:8o patients with hypertension and heart failure admitted to our hospitail from January 2019 to January 2020 were selected as the research subjects,and they were divided into two groups with random number table method,40 cases each.The control group was given conventional treatment regimens,including enalapril and hydroch1orothiazide;the observation group replaced hydrochlorothiazide with indapamide based on the above therapies.The efficacy and systolic blood pressure,diastolic blood pressure and left heart ejection fraction(LVEF)of the two groups were compared.Results:After treatment,the effective rate of the observation group was 92.50%(37/40)higher than that of the control group 75.00%(30/40).The systolic and diastolic blood pressure were lower than those of the control group,and the LVEF was higher than that of the control group.The difference was statistically significant(P<0.05).Conclusion:Enalapril combined with indapamide is effective in the treatment of hypertension with heart failure,which can help 1ower blood pressure,reduce heart 1oad,increase cardiac output,reverse ventricular remodeling,and delay disease progression.
基金grant from Shanghai Science and Technology Commission (99XD14006)
文摘Objective The present study was designed to examine whether the renin-angiotensin system would be implicated in the development of hepatic fibrosis induced by CCI4. The effects of enalapril on the ex-pression of platelet derived growth factor receptor (PDGFR) in liver tissue were also investigated. Methods 50 Sprague-Dawley rats were randomly divided into S groups (control group, model group, and 3 enalapril treated groups). Except rats of the model group, all rats received subcutanous injection of 40% CC14 (every 3d for 6 weeks). Rats of enalapril treated groups were given enalapril (10mg/kg, 5mg/kg, 2.5mg/kg per day, orally)for 6 weeks before they were killed. Serum levels of hyaluronic acid (HA) and laminin (LW) were de-termined by radioimmunoassay techniques. Van Gieson collagen staining was used to evaluate the extracellular matrix of the liver. The expressions of PDGFR and a-smooth muscle actin (a-SMA) were confirmed by im-munohistochemical methods. Results Compared with those in the model gr oup, it was found in enalapril treated groups: (1) serum levels of collagen type 1V and LN were significantly reduced (P< 0. 01); (2) the pro-gression of fibrosis was delayed (P < 0. 01); (3) the expressions of PDGFR and a-SMA were decreased. Conclusion The renin-angiotensin system was involved in the development of hepatic fibrosis induced by Cd4. Angiotensin-converting enzyme (ACE) inhibitor and enalapril could slow down the rate of hepatic fibrosis. This effect might be due to the ability of this drug in suppressing the expression of PDGFR of liver tissue.
基金supported by National Natural Science Foundation of China(No.81641058)
文摘Background The incidence of leg edema caused by calcium channel blockers（CCB） is so high, some studies tried combination with angiotension converting enzyme inhibitors（ACEI） or diuretics to overcome this problem.However, there is no comparison about which is better to improve edema at present. Methods This study was designed as a single-center, prospective, randomized, double-blind, parallel-group, clinical trial. 224 hypertensive patients with leg edema after 4 weeks since taking levamlodipine were enrolled, and they were randomly divided into levamlodipine ＋ furosemide（CD） group and levamlodipine ＋ enalapril（CA） group for another 4 weeks. Ankle circumference（AC）, edema score（ES）, blood pressure（BP） and cure rate of leg edema were evaluated. Results Altogether 179 patients（89 in CD group and 90 in CA group） completed the 4-week treatment. After the 4-week therapy with furosemide or enalapril, most subjects were free of edema in either group（96.51% vs.96.67%, P 〉 0.05）. Only 4 in CD group and 3 in CA group had mild edema. Enalapril was more effective than furosemide to reduce AC（10.92 ± 1.84 mm vs. 12.97 ± 2.46 mm, P 〈 0.05）. But for ES, there was no significant difference. And there were no significant differences in antihypertensive effect between them. Uric acid（UA）was increased significantly in CD group（10.70 ± 18.48 μmol/L vs. 0.22 ± 28.13 μmol/L, P 〈 0.05）. Conclusion Enalapril is more effective than furosemide in attenuating lower extremity edema caused by levamlodipine in essential hypertensive population, with equal antihypertensive efficacy and less uric acid increasing.
文摘The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were enrolled from December 2016 to November 2017.They were randomly divided into two groups,33 patients in each group.Patients in the experimental group received nifedipine.In combination with enalapril,patients enrolled in the control group received nifedipine monotherapy.Compared with the control group,the total effective rate,serum nitric oxide(NO)after treatment,C-reactive protein(CRP)after treatment,homocysteine(HCY)after treatment,and blood pressure after treatment were significantly improved(P<0.05).There were no significant differences in serum NO,pre-treatment CRP,pre-treatment HCY,pre-treatment blood pressure,and adverse reactions during treatment between the two groups(P>0.05).The elderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.
