高血压患者使用依普利酮治疗的效果

（Inspra）是第一个选择性醛固酮受体拮抗剂，已经用于治疗高血压病和急性心肌梗死后左室功能不全，能有效降低血压，改善心功能，减轻心肌损伤。国内常用的醛固酮受体拮抗剂螺内酯对心血管系统有显著的保护作用，但醛固酮具有多种病理生理作用，可以引起中枢性高血压，加速内皮损伤(儿茶酚胺增强其作用)，降低心率变异，诱发室性心律失常，促进钠潴留、钾和镁丢失，促进心肌纤维化、坏死及炎症，损害纤维蛋白溶解系统。

依普利酮对雄激素和黄体酮受体的亲和力极低，不良反应小，是螺内酯的良好替代药物，作为新一代选择性醛固酮受体拮抗剂为心血管疾病的治疗提供了新方法。

In patients with low-renin hypertension, eplerenone (Inspra) has a better antihypertensive effect than losartan. For patients with hypertension who are poorly controlled by ARB alone, adding eplerenone (50~100 mg·d) for 8 weeks can further enhance the effect of reducing systolic blood pressure (SBP) and diastolic blood pressure (DBP).对于 ACEI 或 ARB 控制不佳的老年高血压患者，加用低剂量( 25~50 mg/d，平均 37. 5mg) 的依普利酮可有效降低平均 24 h 的收缩压（SBP） 和舒张压（DBP）。

In addition, combined use with enalapril can significantly reduce left ventricular weight, and the addition of hydrochlorothiazide and amlodipine can further reduce it. Previous studies have confirmed that left ventricular mass index is associated with event-free survival. In studies on patients with diabetes mellitus and proteinuria, both eplerenone (Inspra) and enalapril can reduce systolic blood pressure and diastolic blood pressure, while eplerenone reduces the urinary albumin/inosine ratio UACR more significantly than enalapril.

Recommended related hot articles: /newsDetail/73021.html