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[Abstract] Objective To study the therapeutic effect and responding time of low-flow oxygen combined with fosinopril on treatment of acute plateau heart disease. Methods Ninety young male officers and soldiers, diagnosed as acute plateau heart disease after rushing into the plateau (Ali region of Tibet, 4300 m) from the plain area and admitted to the Shiquanhe Medical Station in Ali Military Division from Sep. 2017 to Apr. 2018, were recruited in present study. All the subjects were randomly divided into 3 groups: group A were treated with low-flow oxygen (2 L/min, 60 min, twice a day), group B were treated with fosinopril (10 mg/d), and group C were treated with low-flow oxygen (2 L/min, 60 min, twice a day) combined with fosinopril (10 mg/d). Echocardiography was performed 2, 4 and 6 weeks after treatment to detect the pulmonary artery inner diameter (PAD), inner diameter of right outflow ventricular tract (ROVT), mean pulmonary arterial pressure (MPAP) and right ventricular Tei index (RV-Tei), the test results were then compared among the 3 groups to evaluate the therapeutic effect. Results Two weeks after treatment, the PAD, ROVT, MPAP and RV-Tei in group C [(21.66±3.49) mm, (25.81±2.33) mm, (22.37±2.78) mmHg and (0.24±0.05)] were significantly lower than in group A and group B [(28.37±3.75) mm and (27.29±2.91) mm; (31.25±5.27) mm and (30.34±5.66) mm; (28.25±4.17) mmHg and (27.11±4.94) mmHg; and (0.33±0.08) and (0.32±0.05)] with statistical differences (P0.05). Four weeks after treatment, the PAD, ROVT, MPAP and RV-Tei in group B and group C [(22.21±1.76) mm and (21.17±1.97) mm; (25.29±3.71) mm and (24.30±1.99) mm; (23.91±2.63) mmHg and (21.03±3.17) mmHg; and (0.23±0.06) and (0.23±0.05)] were significantly lower than in group A [(25.09±3.75) mm; (29.38±3.06) mm; (27.87±3.71) mmHg; and (0.29±0.05)] with statistical differences (P0.05). Six weeks after treatment, for PAD, ROVT, MPAP and RV-Tei no significant difference existed among group A, group B and group C [(22.71±2.86) mm, (21.29±2.56) mm, (20.39±2.03) mm; (24.08±3.51) mm, (23.15±3.08) mm, (23.02±2.31) mm; (23.42±1.79) mmHg, (22.88±2.77) mmHg, (21.72±2.49) mmHg; and (0.23±0.04), (0.22±0.06), (0.22±0.06)], and all the measured values reached normal level. Conclusion Low-flow oxygen combined with fosinopril therapy is more effective in curing acute plateau heart disease, and in preventing right heart failure caused by plateau heart disease.
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Objective To compare three different anti-hypertension therapeutic projects by pharmacoeconomic evaluation and to find out the best therapeutic project.Methods Retrospective study was used.120 patients with hypertension were ran-domly assigned to group A(fosinopril sodium),group B(valsartan),group C(amlodipine besylate tablet),the therapeutic effects were observed and were evaluated by cost minimization analysis.Results The total efficiency of A,B,C group were 90·7%, 92·3%,92.1%(P>0.05)respectively.The incidence of adverse reaction were 16.7%,7.7%,13.2%(P>0.05)respective-ly.The costs were 287.3 yuan,378.7 yuan and 320.4 yuan respectively.Conclution The effectiveness of the three groups was similar.In terms of pharmacoeconomics,group A was the best therapeutic project.
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OBJECTIVE: To observe the improvement effects of angiotensin converting enzyme inhibitor (ACEI) fosinopril, perindopril and benazepril on ventricular remodeling in patients with acute myocardial infarction (AMI), and to evaluate its safety. METHODS: A total of 96 AMI patients selected from our hospital during Jan. 2014-Oct. 2016 were divided into group A, B, C according to random number table, with 32 cases in each group. All patients received symptomatic treatment, underwent percutaneous coronary intervention, and then given ACEI after blood vessels recanalization and keeping blood pressure stable. Group A was given Fosinopril sodium tablets 10 mg, qd; group B was given Perindopril tert-butylamine tablets 4 mg, qd; group C was given Benazepril hydrochloride tablets 10 mg, qd. All groups were treated for consecutive 6 months. Cardiac structure and function indexes (LVESD, LVEDD, IVSD, LVPWD, LVEF, CO), hemodynamic indexes (SBP, DBP, HR) and related lab indexes (FPG, TG, TC, HDL-C, LDL-C, AST, ALT, Scr, BUN) of 3 groups were observed before and after treatment. The occurrence of ADR was recorded. RESULTS: Before treatment, there was no statistical significance in cardiac structure and function indexes, hemodynamic indexes or related lab indexes among 3 groups (P＞0. 05). After treatment, the levels of LVESD, LVEDD, LVPWD, CO, HR, FPG, TG, TC and LDL-C in 3 groups were decreased significantly, while the levels of LVEF and SBP were increased significantly, with statistical significance (尸＜0. 05). There was no statistical significance in above indexes among 3 groups after treatment (P＞0. 05). After treatment, the level of Scr in group B was significantly increased and higher than group A and C, with statistical significance (P＜0. 05). There was no statistical significance in the levels of IVSD, DBP, HDL-C, AST, ALT or BUN among 3 groups before and after treatment as well as the level of Scr between group A and C (P＞ 0. 05). There was no statistical significance in the incidence of ADR among 3 groups(P＞0. 05). CONCLUSIONS: Fosinopril, perindopril and benazepril can significantly improve ventricular remodeling in AMI patients, narrowing the heart cavity, increasing systolic pressure, lowering heart rate, reducing the oxygen consumption of the ventricle, with similar effects. Perindopril may increase the level of Scr, so fosinopril and benazepril are safe and suitable for AMI patients with renal function disorder.
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Objective To evaluate the efficacy of Scrophularia ningpoensis granules combined with fosinopril in treatment of congestive heart failure.Methods 60 congestive heart failure patients were randomly divided into 2 groups, 30 patients in the treatment group and 30 patients in the control group.Besides the conventional therapy, the control group was treated with fosinopril and the treatment group received Scrophularia ningpoensis granules plus fosinopril for 90 days.Left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and serum B-type brain natriuretic peptide (BNP) were measured before and after treatment.Results The total effective rate in the treatment group and the control group were 90%, but significantly effective number in the treatment group was higher than the control group.The levels of BNP, LVEDD and LVESD in both groups were decreased, while LVEF was increased after the treatment.The difference was statistically significant (P<0.01).The degree of improvement of heart function in the treatment group was better than that in the control group (P<0.05).Conclusion The combination therapy of Scrophularia ningpoensis granules and fosinopril is efficacious in treating CHF.
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Objective: To explore the effects of fosinopril on oxidative stress and vascular function in experimental rats with spontaneous hypertension. Methods: The rats were divided into 3 groups: Control group, with normal healthy rats (n=15), Spontaneous hypertension (SH) group (n=15), SH rats received intragastric administration of normal saline and Treatment group (n=15), SH rats received intragastric administration of fosinopril 10mg/(kg?d). All animals were treated for 7 weeks. Caudal artery systolic blood pressure (SBP) was measured at each week. blood levels of superoxide dismutase (SOD), reactive oxygen species (ROS), malonaldehyde (MDA) and NO2-/NO3- were determined in different groups respectively after 7 weeks. Moreover, thoracic aorta was taken to examine its diastolic reactive rate by acetylcholine (Ach)/sodium nitroprusside (SNP) induction. Results: From the 1st week until the end of experiment, compared with SH group, Treatment group had decreased SBP,P<0.05. With 7 weeks treatment, compared with Control group, SH group had decreased SOD activity, while increased protein levels of MDA and ROS, allP<0.05; compared with SH group, Treatment group showed elevated SOD activity (P=0.010), while reduced protein levels of MDA (P=0.021) and ROS (P=0.009). Compared with Control group, SH group had the lower content of NO2-/NO3-(P<0.001); both SH group and Treatment group had decreased diastolic rates by Ach/SNP induction,P<0.05. Compared with SH group, Treatment group presented the higher content of NO2-/NO3- and higher diastolic rate by Ach induction, allP<0.001. Conclusion: Fosinopril could improve vascular diastolic function via anti-oxidative stress in experimental SH rats, which might be one of its anti-hypertensive mechanisms.
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Objective To study the effect and mechanism of the Fosinopril combined with Fenofibrate on the prevent?ing of diabetic retinopathy. Methods A total of 150 viripotent ICR mice(100 male mice, 50 female mice) were randomly di?vided into five groups(n=30), including A group (Sham group), B group (Model group), C group [Fosinopril prevented group, 20 mg/(kg·d)], D group [Fenofibrate prevented group, 400 mg/(kg·d)] and E group (Fosinopril combined with Fenofibrate pre?vented group). The expression levels of Bax and Bcl-2 gene mRNA were determined by RT-PCR method. TUNEL staining method was used to detect the apoptosisi of retinal cells. Results The Bcl-2 mRNA of A group, Bax mRNA of B group were higher than those of other four groups. Bcl-2 mRNA of E group was higher than that of C group and D group, while the Bax mRNA was lower than those of two groups(all P<0.05). The TUNEL index of B group was the highest than other groups, which of E group
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Objective: To investigate the effects of fosinppril on myocardial cell apoptosis and apoptosis-associated gene expression in chronic heart failure (CHF) rats. Methods: CHF model was established by partially banding of abdominal aorta superior to renal artery. The experimental rats were randomly divided into 3 groups: Sham operation group and CHF group, the rats in both groups received stomach normal saline; Fosinopril group, the rats received stomach fosinopril 10 mg/kg?d.n=10 in each group and all animals were treated for 8 weeks. LVEDP, ±dp/dtmax and LVMI were examined, left ventricular myocardial cell apoptotic index (AI) was measured by TUNEL method, Bcl-2 and Bax protein levels were detected by immunohistochemistry and caspase-3 protein expression was assessed by Western blotting. Results: Compared with Sham operation group, CHF group had increased LVEDP, LVMI, AI, elevated protein expressions of Bax and Caspase-3,P Conclusion: Fosinopril may inhibit myocardial cell apoptosis which occurred during CHF, by up-regulating Bcl-2 expression and down-regulating expressions of Bax and Caspase-3 in CHF rats, therefore improve the cardiac function.
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Objective To investigate the effects ofShipi-Gushen-Huayu Recipe on the expressions of collagen I, laminin(LN), transforming growth factor-β1(TGF-β1)andα-smooth muscle actin(α-SMA)in adriamycin-induced renal fibrosis in rats.Methods A total of male SD rats were randomly divided into four groups, with 10 rats in each group: a normal group, a model group, a treatment group and a fosinopril sodium group. Except the rats in the normal group, the rest rats were subjected to renal fibrosisvia tail intravenous injection of adriamycin(4 mg/kg). Two weeks after modeling, the rats in the rreatment group and in the fosinopril sodium group were intragastrically administrated daily withShipi-Gushen-Huayu Recipe extract(43 g/kg)and fosinopril solution(2 mg/kg), respectively,both in the normal group and model group with saline. After 30 days, 24-hours urine protein were determined, and the expressions of collagen I, LN, TGF-β1 andα-SMA in kidney tissue were detected with immunohistochemistry staining.Results The expressions of collagen I(24.64±0.67vs. 32.86±0.88), LN(18.71±0.72vs. 28.35±0.87), TGF-β1(14.71±0.68vs. 18.35±0.96)andα-SMA(17.64±0.74vs. 25.86±0.85)in the treatment group were significantly lower than those in the model group(allP<0.01). The expressions of collagen I, LN, TGF-β1 andα-SMA in the fosinopril sodium group were 27.33±0.73, 20.44±0.81, 15.44±0.85 and 19.33±0.77, respectively. There was no statistically significant difference between the expressions of collagen I, LN, TGF-β1 andα-SMA in the treatment group and in the fosinopril sodium group.ConclusionShipi-Gushen-Huayu Recipe can significantly down regulate the expressions of collagen I, LN, TGF-β1 andα-SMA in adriamycin-induced renal fibrosis in rats.
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Objective To observe the effects of one kind of angiotensin converting enzyme inhibitor (ACE1) drugs fosinopril (FOS) on transforming growth factor β1 (TGF-β1)and β1- integrin( Itg-31 ) expression in rat glomerular mesangial cells (GMC)induced by lipopolysacchatide (LPS).Methods We established the cultured glomerular mesangial cells of rat in vitro and passages 3 ～ 10 of cells were used in the experiment after identification.The experiment included the following groups:Control group,LPS induced group (LPS group) and FOS intervened group.According to the different concentrations of FOS,FOS intervened group was divided into high,middle and low dose FOS groups,which were FOS1 group,FOS2 group and FOS3 group respectively.The changes of TGF-β1 protein secretion was detected by the enzyme-linked immunosorbent-assay; The changes of TGF-β1 and Itg-β1 mRNA expression was detected by quantitative real-time RT-PCR.Results (1) TGF-β1protein secretion in rat GMC at 6h,12h,24h three time points:They were 958.55 ± 34.67 ( ng/L),1052.05 ±48.59( ng/L),1166.06 + 35.39 (ng/L) respectively in Control group.They were 1342.12 + 39.87 ( ng/L),1432.31 + 39.33 (ng/L) and 1 537.77 + 43.79 (ng/L) respectively in LPS group,which were higher significantly than those in Control group ( all P ＜ 0.01 ).They were 779.58 ± 48.64 ( ng/L),878.33 ± 29.50 (ng/L) and 962.57 ±31.94( ng/L) in FOS1 group,989.311±73.56(ng/L),1073.29±66.89(ng/L) and 1210.75 ±61.68(ng/L) in FOS2 group,1 253.78 ±45.32( ng/L),1 348.18 ±45.81 (ng/L) and 1450.06 ±46.24( ng/L) in FOS3 group respectively,which were lower significantly in all FOS intervened groups than that in LPS group (all P＜O.01).(2)TGF-β1 mRNA expressions in rat GMC at6h,12h,24h three time points were higher significantly than that in Control group.TGF-β1 mRNA expressions were lower significantly in all FOS intervened groups than that in LPS group.( 3 ) Itg-β1 mRNA expressiones in rat GMC at 6h,12h,24h three time points were higher significantly than that in Control group.Itg-β1 expressions were lower significantly in all FOS intervened groups than that in LPS group.Conclusions LPS can induce the increase of TGF-β1 secretion and mRNA expression.FOS can inhibit the TGF-β1 secrection and mRNA expession in GMC as dose-dependent manner,at the same time down regulated the Itg-β1 mRNA expression iuduced by LPS.All above supply the theoretical evidence for the renal protection of FOS by non-hemodynamics mechanism.
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Objective To explore effects of fosinopril and losartan on renal Klotho expression and oxidative stress in spontaneously hypertensive rats (SHR) and the mechanisms underlying the protection against renal damage. Methods Fifteen male SHRs (22 weeks old) were randomly divided into 3 groups (n=5 in each group): a SHR group, a fosinopril group ［10 mg/(kg?d)］, and a losartan group ［50 mg/(kg?d)］. Age-matched Wistar-Kyoto (WKY) rats were chosen for a control group. Eight weeks later, tail arterial pressure, 24 hours urinary protein (Upro)，urinary N-acetyl-β-D-glucosaminidase (NAGase) were measured. Renal pathological changes were examined under light microscopy by HE staining. The renal mRNA and protein expression of Klotho were determined by RT-PCR, immunohistochemical staining or Western blot. The levels of total antioxidant capacity (TAOC), malondialdehyde (MDA), Cu/Zn superoxide dismutase (Cu/Zn-SOD), Mn superoxide dismutase (Mn-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were determined.Results The typical pathological characteristics of hypertensive renal damage were observed in the kidney of the SHR group．Compared with the SHR group, the systolic pressure, Upro, and urinary NAGase, the content of MDA and renal pathological damage was reduced while the renal Klotho expression and activities of TAOC, Cu/Zn-SOD, CAT, and GSH-Px were increased (P<0.05 or P<0.01) in the fosinopril or losartan group. There was no significant difference in renal Mn-SOD level among the 4 groups (P>0.05). Conclusion Fosinopril and losartan can exert protection against hypertensive renal damage through upregulating Klotho expression as well as reducing oxidative stress.
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Objective To investigate the possibility and utility of metformin alone or in combination with fosinopril to reduce blood pressure in patients with essential hypertension.Met hods A total of 140 cases of non-diabetic essential hypertension with hyperinsulinemia were recruited and randomly assigned to two groups: a group of 68 treated with metformin 500 mg tid and a group of 72 treated with fosinopril 10 mg qd.The duration of the treatment was 8 weeks.Combination therapy with the two drugs was used after 4 weeks of treatment if needed.If the target goals of systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg =0.133 kPa) and /or diastolic blood pressure (DBP) <90 mm Hg were not attained 4 weeks, combination therapy with two drugs was used in either group in the next 4 weeks.The changes of blood pressure and insulin sensitivity of the two groups were observed before and after treatment.Results (1) After 4 weeks of treatment, SBP in metformin group and fosinopril group decreased by ( 13.0 ± 1.2) mm Hg and (15.4 ± 1.4) mm Hg, and DBP decreased by (9.0 ± 1.0) mm Hg and ( 10.4 ± 1.1 ) mm Hg respectively.After 8 weeks of treatment, SBP in metformin group and fosinopril group decreased by (17.8 ± 1.5) mm Hg and (20.9 ± 1.5) mm Hg, and DBP decreased by (13.2 ±0.9) mm Hg and (15.3 ± 1.1) mm Hg respectively.There was no significant difference in the decline of blood pressure between the two groups (P >0.05).The rates of combination therapy were both 54% in the two groups.(2) Fasting insulin as well as 30 min and 120 min insulin levels after oral glucose tolerance test and insulin area under the curve in the metformin group were significantly reduced after 4 and 8 weeks of treatment as compared with those of baseline(P < 0.05 and P < 0.01 ) .In the fosinopril group, however, they decreased only after 8 weeks treatment (P < 0.05).The insulin action index in the metformin group was higher than that in the fosinopril group after 4 weeks of treatment (P <0.05) ,but there was no significant difference between the two groups after 8 weeks of treatment (P > 0.05).Conclusion Metformin and fosinopril have similar antihypertensive effect and a good synergy in essential hypertension with hyperinsulinemia.
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Objective To observe the effects of fosinopril(FOS)on secretion of ColⅠ,expression of Smad2、Smad7 mRNA in TGF-β1-induced glomerulomesangial cells(GMC)in rat model. Methods Rat glomerular mesangial cells were cultured in vitro,passages 3 - 10 cells were used in the study after identification,and the cells were divided into 3 groups:control group(Ctrl group),TGF-β1 group,and fosinopril group. Expression of Col Ⅰ in cell culture supernatant was detected by the enzyme-linked immunosorbent assay(ELISA)at 6 h,24 h and 48 h. Changes of Smad2,Smad7 mRNA expression were evaluated by fluorescent quantitation PCR. Results Glomerular mesangial cells had Col Ⅰ protein expression. Secretion of Col Ⅰ was significantly higher in TGF-β1 group than those in Ctrl group at each time point(P ＜ 0.01),however the Col Ⅰ was significantly lower in fosinopril group at all time points than that in TGF-β1 groups(P ＜ 0.05). Glomerular mesangial cells also had Smad2,Smad7 mRNA expressions. The expressions of Smad2,Smad7 mRNA were significantly higher in TGF-β1 group than those in Ctrl group at each time point. Expression of Smad2 mRNA was significantly lower in fosinopril group than that in TGF-β1 group at all time points,while the difference in Smad7 mRNA expression between TGF-β1 group and fosinopril group showed no statistical significance(P ＞ 0.05). Conclusions Fosinopril could inhibit the secretion of Col Ⅰ and expression of Smad2 mRNA in glomerular mesangial cells induced by TGF-β1,suggesting that fosinopril might delay glomerular sclerosis through inhibiting the expression of Smad2 in TGF-β1/Smad signaling pathway.
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AIM:To observe the clinical effects of Huangkui Capsule (Abelmoschus manihot (Linn)Medic.)on the treatment of IgA nephropathy of damp-heat syndrome.METHODS: Sixty-four patients were assigned randomly into two groups: treatment group in which 32 cases were treated with Huangkui Capsule,and control group,in which 32 cases were treated with fosinopril.The therapeutic course for both groups was 12 weeks.The indexes of efficacy ,including damp-heat syndrome scores,24 h urinary protein,serum creatinine,urea nitrogen and the indexes of safety,including liver function,electrolyte and occurrence of adverse events were observed.RESULTS :There was no significant statistical difference between the two groups in aspects of baseline clinical figures,after 12 weeks of treatment,the content of 24h urinary protein significantly decreased by (0.49±0.78 )g/24 h and (0.4±0.76 ) g/24 h respectively in the two groups,showing significant difference in comparing with baseline,but insignificant difference between the two groups ( P ＞ 0.05 ),the scores of damp-heat syndrome in the two groups decreased by (0.88±1.43 ) scores and (1.94±1.63 ) scores respectively with significant difference as compared with baseline (P ＜0.05 ),and in comparison between groups(P ＜0.05 ).The total effective rate of 24 h urinary protein was 53.1% in the treatment group and 65.6% in the control group (P ＞ 0.05 ),The total effective rate of dampheat syndrome scores was 84.4% in the treatment group and 50% in the control group ( P ＞ 0.05 ).No significant change in levels of serum creatinine,urea nitrogen in the two groups was found (P ＞0.05 ).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION: Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.
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Objective To explore whether or not the function of atragalus membranaceus combined fosinopril on decreasing NF- κB activity and OPN expression in overload albumin stimulating proximal tubuler cells. Methods Cultured cells without stimulation were used as placebo. Cultured cells were incubated with bovine serum albumin fat acid free (BSA) 20mg/ml as the control. Cultured cells were incubated with fosinopril for different hours as the treatment. Cultured cells were incubated with atragalus membranaceus combined fosinopril for different hours as the atragalus membranaceus group. ELISA and RT-PCR were used to observe NF -κB activity and OPN expression after cultured for 12h, 24h. Result Atragalus membranaceus combined fosinopril rapidly decreased NFκB activity and OPN expression. Compared with the other groups, the difference was significant. Conclusion Astragalus membranaceus combined fosinopril can obviously decrease NFκB activity and OPN expression in overload albumine stimulating proximal tubular cells.
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Objective To investigate the expression of adiponectin Mrna in adipose tissues of spontaneously hypertensive rats (SHR) and the effects of Fosinopril (Fos) and osartan (Los) on adiponectin Mrna.Methods Twenty 22 - week old male SHR rats were randomly divided into four groups:SHR group,Fos group,and Fus + Los group.Five 22 - week old male WKY rats were used as control.The body weigh,cuff-tail blood pressure,urinary microprotein and urinary N-acetyl-β-D-glucesaminidase were determined.RT-PCR were applied to determine the expression of adiponectin Mrna in adipose tissues.Results At the eighth week,systolic blood pressure of rats in SHR group was significantly higher than those in the other four groups (P＜0.05).The levels of urinary microprotein,urinary NAGase in the WKY group,Fos group,Los group and Fos + Los group were significantly lower than those in SHR group(P＜0.05).RT-PCR analysis revealed that the expression of adiponectin Mrna in SHR group was obviously decreased,compared with WKY goup.Adiponectin Mrna expression in Los group,Fos group and Fos + Los group were increased compared with SHR group(P＜0.05).Conclusions The expression of adiponeetin Mrna is down-regulated in adipose tissues of SHR.After intervention with Fusinopril and Losartan,the adiponectin Mrna expression was up-regulated in adipose tissues of SHR,the levels of urinary microprotein and urinary NAGase were obviously increased in SHR and the levels of urinary microprotein and urinary NAGase were obviously decreased.
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Objective To observe the treatment effect of renal function and blood pressure in patient with blood pressure morning surge.Methods 34 patients take levoamlodipine 2.5 mg/q orally.35 patients take Fosinopril 10 mg/q orally.35 patients take Fosinopril lOmg/q and levoamlodipine 2.5 mg/q orally,continuing 12 months. Blood pressure,urinary albumin excretory rate,scrllm creatinine,urinary creatinine and calculated creatinine clearance at base line were measured.Results Blood pressure (P<0.01) and urinary albumin excretory rate (P<0.01) were decreased by compare to pretherapy in three groups.Post-treatment,urinary albumin excretory rate was reduced from 103.8±44.2 to (84.6±37.5)μg/min in the first group,from 102.9±45.4 to(82.7±38.4)μg/min in the second group,and from 109.8±40.5 to(51.2±40.1)μg/min in the last group.The difference for urinary albumin excretory rate was significant between prior treatment and post-treatment in every group (P<0.05).It is the same between the first group and the second.The difference for urinary albumin excretory rate was significant between the first group and the third group (P<0.01).The difference was significant between the second groud and the third group (P<0.01).Post-treatment,calculated creatinine clearance rate was increased from 84.6±7.4 to 88.2±7.1 in the first group,from 81.4±2.5 to 84.5±4.2 in the second group,and from 79.1±6.8 to 109.6±16.1 in the last group.The difference for calculated creatinine clearance rate was significant between prior treatment and post-treatment in the third group (P<0.01).Conclusion Blood pressure (P<0.01) and urinary albumin excretory rate were decreased by three methods.Three methods all protect renal function,and the third method is the best.
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Objective:To investigate the effect of telmisartan and fosinopril on the expression of angiotensin-convertion enzyms 2 (ACE2) in cardiomyocyte after myocardial infarction.Methods:Animal model of acute myocardial infarction were established by ligating the left anterior descending coronary artery of rats. Vehicle, telmisartan,fosinopril,or both drugs combined were giv- en to rats by intubation feeding,from 2 weeks before coronary artery ligation to 2 weeks there after. ACE2 protein expression of myocardium were semi-quantified by SP immunohistochemistry. ACE2mRNA were measured by Reverse Transcriptase Poly- merase Chain Reaction (RT-RCR). Results:Compare with sham operated group,ACE2 protein increased significantly in infarc- tion group,but not the ACE2 mRNA. telmisartan and fosinopril therapy caused a significant increase in ACE2 protein compare to infarction group,but only telmisartan caused a significant increase in ACE2 mRNA though all therapied groups showed higher ACE2 mRNA expression. Conclusion:Both telmisartan and fosinopril induced increases in cardiac ACE2 exprssion, whereas the combination of these two drugs do not associated with higher ACE2 expression.
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Objective To evaluate the the effect of microalbuminuria of combined treatment with fosinopril and losartan,or fosinopril,losartan monotherapy in patients with hypertension.Methods In this double-blind, intention to treat study,136 patients with hypertension were randomly assigned to receive fosinopril 10 mg/d(n= 50),losartan 50 mg/d(n=41),or a combination of fosinopril 5 mg and losartan 25 mg (n=45) qd for 4 weeks, followed by titrating to the maximum recommended doses for another 4 weeks.The primary endpoint was the difference of mean sitting blood pressure and microalbuminuria excretion at baseline and week 8.Results At week 8,the combination of fosinopril and losartan therapy lowered mean mieroalbuminuria from baseline by 26.1?10~(-8) mol/L,significantly more than either monotherapy approaches (fosinopril 20 mg,18.3?10~(-8)mol/L,P
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Objective To explore the effect of fosinopril on plasma biomarkers of endothelial cell in elderly patients with type 2 diabetes mellitus complicated with hypertension. Methods Fourty-two patients with type 2 diabetes mellitus complicated with hypertension were treated with fosinopril (10～20)mg/d for 6 months. Twenty-four matched healthy people were selected as control. Before treatment and after 6 months of treatment,thromodulin (Tm),von willebrand factor and nitric oxide (NO) as well as systolic pressure (SBP) and diastolic pressure (DBP) were detected. The reactive congestion and nitroglycerin-induced dilation of the right brachial artery were assayed with high-resolution ultrasound. Results After 6 months of treatment in all patients,diameters of brachial artery after taking glyceryl trinitrate showed no change markedly,but the plasma levels of Tm and vW factor were decreased and NO was increased obviously than those before treatment. The diameter of brachial artery in responding to reactive hyperaemia was improved greatly and the SBP & DBP were all decreased obviously than those before the treatment. Concusion Fosinopril effectively reduces blood pressure and the endothelial-dependent vasodilatation companied with decrease of the plasma Tm & vW factor and increase of the plasma NO in patients with type 2 diabetes mellitus complicated with hypertension.
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Objective To observe the effects of fosinopril(FOS),a new generation angiotensin-converting enzyme inhibitor(ACEI),on protein and mRNA expression of transforming growth factor-?_1(TGF-?_1) of rat glomerular mesangial cell(GMC) induced by lipopolysaccharide(LPS);to demonstrate the preventive mechanism against glomerular sclerosis by applying FOS.Methods The cultured GMC in classic way were divided into 3 groups:control group;LPS group;LPS+FOS group.TGF-?_1 concentration in GMC supernatant fluid was detected by ELISA;TGF-?_1 mRNA expression was determined by semiquantitative real-time RT-PCR.Results LPS group was obviously higher than control groups in TGF-?_1 secretion and mRNA expression,while LPS+FOS group decreased distinctively in TGF-?_1 secretion and mRNA expression compared with LPS group.Conclusions FOS has obviously inhibited on TGF-?_1 expression of rat GMC both at protein level and mRNA level,which reveals that it may be an important mechanism by FOS on restraining the development of glomerulosclerosis.