超声背向散射技术评价t-PA和PAI-1对高血压左室心肌胶原网络重构的影响  

Effect of t-PA and PAI-1 on Left Ventricular Myocardial Collagen Network Remodeling in Patients with Essential Hypertension Using Integrated Backscatter

作　　者：卜培莉[1] 孙敬春[2] 张运[1] 钟明[1] 侯晓阳[1] 朱媛媛[3] 

机构地区：[1]山东大学齐鲁医院心内科,济南市250012 [2]山东省单县中心医院心内科 [3]山东大学齐鲁医院血液病室,济南市250012

出　　处：《中国超声医学杂志》2006年第3期197-199,共3页Chinese Journal of Ultrasound in Medicine

基　　金：山东省卫生厅科学研究基金(No.2001CA1CJA8)资助

摘　　要：目的测定原发性高血压患者血浆组织型纤溶酶原激活剂(t-PA)及其抑制物(PA I-1)水平及左室超声背向散射积分(IBS)参数的变化,评价纤溶活性在心肌胶原网络重构发生、发展中的作用。方法按WHO/ISH(1999年)高血压诊断标准选择原发性高血压(EH)患者106例,正常对照组30例。根据左室质量指数将高血压患者分为左室肥厚(EH-LVH)组50例及非肥厚(EH-NLVH)组56例。用ELISA法测血浆t-PA与PAI-1含量,HP Sonos5500型多普勒超声仪测定室间隔IBS参数(AII、PPI、CAI),并对上述指标的相关性进行分析。结果与对照组相比,EH-LVH组和EH-NLVH组PAI-1、AII、CAI升高,t-PA、PPI降低,与EH-NLVH组相比,EH-LVH组AII、CAI升高,t-PA降低。相关分析显示:PAI-1与AII、CAI、LVMI呈正相关关系,与PPI呈负相关关系;t-PA与AII、CAI、LVM呈负相关关系,与PPI呈正相关关系。结论高血压患者存在纤溶功能异常和心肌及胶原网络重构,血浆PAI-1升高和t-PA降低在左室心肌及胶原网络重构的形成中发挥了一定的作用。Objective To evaluate relations between the serum of plasmatic tissue-type plasminogen activator （t-PA）, plasminogen activator inhibitor-1 （PAI-1） concentration and echocardiographic integrated backscatter （IBS） in patients with essential hypertension （EH） . Methods The study was performed in 106 EH （50 patients with left ventricular hypertrophy as EH-LVH group and 56 patients without Left ventricular hypertrophy as EH-NLVH group） and 30 normotensive control subjects. The plasmatic concentration of t-PA and PAI-1 was measured with ELISA. IBS parameters such as average image intensity （AII） and peak to peak intensity （PPI） of interventricular septum were measured echocardiographically. Results AII and corrected acoustic intensity （CAI） in the EH-LVH and EH-NLVH groups were higher than those in the control group. PPIs were lower. PAI-1 in EH-LVH and EH- NLVH groups was increased than that in the control group. The t-PA was decreased in EH-LVH and EH-NLVH groups and was lower in EH-LVH group than that in EH-NLVH group. All was correlated with PAI-1 and t-PA （r= 0.57, -0.51 respectively） . The PAI-1 and t-PA were correlated with LVMI （r= 0.67, -0.58 respectively）. Conclusions The findings showed that PAI-1, t-PA had taken part in myocardial collagen network remodeling.

关 键 词：高血压病 胶原 背向散射积分 纤维蛋白溶酶原活化抑制剂 组织型纤维蛋白溶酶原活化剂 

分 类 号：R445.1[医药卫生—影像医学与核医学]