高血压不同左心室构型患者血清PCⅠ和PCⅢ含量及其临床意义  

STUDY ON THE RELATIONSHIP BETWEEN LEFT VENTRICULAR GEOMETRY AND SERUM PROCOLLAGEN TYPE Ⅰ AND TYPE Ⅲ IN ESSENTIAL HYPERTENSIVE PATIENTS

作　　者：艾庆[1] 于小亮[1] 王兴祥[2] 

机构地区：[1]湖南省怀化市第一人民医院心血管内科,湖南怀化418000 [2]浙江大学医学院第一附属医院心内科,浙江杭州310003

出　　处：《实用临床医药杂志》2006年第2期53-56,共4页Journal of Clinical Medicine in Practice

摘　　要：目的初步探讨血清Ⅰ和Ⅲ型前胶原(PCⅠ、PCⅢ)对高血压患者左室重构不同构型的影响。方法采用放射免疫法测定140例高血压患者和30例健康体检者的PCⅠ、PCⅢ浓度;超声心动图检查心脏各结构指标,据此将高血压组分为正常构型组(25例)、向心性重构型组(43例)、向心性肥厚型组(40例)和离心性肥厚型组(32例)4个亚组。结果①高血压组的血清PCⅠ和PCⅢ水平均显著高于正常对照组;高血压不同左心室构型组间,血清PCⅠ和PCⅢ水平均有统计学差异(P<0.05),但两者在不同构型间升高的情况有所不同,血清PCⅢ水平在向心性与离心性肥厚组显著升高,但两肥厚组间无显著差异,而血清PCⅠ水平在离心性肥厚组显著高于其他各组(P<0.05);高血压正常构型与向心性重构型组的PCⅠ水平虽高于正常对照组,但差异不显著。②血清PCⅠ和PCⅢ均与左室质量指数、左心室室壁相对厚度、室间隔厚度和左室后壁厚度呈正相关;血清PCⅠ与PCⅢ亦呈正相关。结论血清PCⅠ和PCⅢ水平升高均与高血压病左心室重构有关,临床上检测血清PCⅠ和PCⅢ水平有助于尽早发现高血压病左心室重构,并为逆转左心室重构提供客观的监测指标。Objective To investigate the effect of serum procollagen type Ⅰ （PC Ⅰ ） and procollagen typeⅢ （PCⅢⅠ） levels on left ventricular geometry in essential hypertension. Methods There xere 140 essential hypertensive patients and 30 control subjects in this study. Hypertensive patients were classified into four groups according to echocardiographic findings that showed normal geometry, concentric remodeling, eccentric hypertrophy, or concentric hypertrophy. Serum PC Ⅰ and PCⅢ were measured by radioimmunoassay. Results （1） The levels of serum PC Ⅰ and PCⅢ in essential hypertensive patients were higher than those in normotensive control subjects （P 〈 0.05）; the levels of serum PCⅢ in hypertensive patients with eccentric hypertrophy and concentric hypertrophy were higher than those in other groups （P 〈 0.05）, while there were no differences between the two hypertrophy groups （P 〉0.05）; the level of serum PCⅠ in hypertensive patients with eccentric hypertrophy was highest among all groups（P 〈 0.05）, and tended to be higher in hypertensive patients with concentric remodeling and normal geometry than those in normotensive control subjects. However , the differences were not significant （ P 〉 0 . 0 5 ） . （2） Both serum PCⅠ and PC Ⅲ were significantly correlated left ventricular mass index , relative left wall thickness , interventricular septal thickness, left ventricular posterior wall thickness; In addition, serum PCⅠ levels were well correlated with serum PCⅢ levels. Conelusion serum PC Ⅰ and PCⅢ play an important role in left ventricular remodeling, and may be reliable objective markers for existence and reversal of left ventricular remodeling in patients with essential hypertension.

关 键 词：高血压 左心室重构 Ⅰ、 Ⅲ型前胶原 心肌纤维化 

分 类 号：R544.1[医药卫生—心血管疾病]