缬沙坦逆转原发性高血压患者左心室肥厚的相关因素  

Investigation of relating factors in left ventricular hypertrophy reversion by valsartan in patients with essential hypertension

作　　者：张莉娜[1] 毛艳华[2] 石斗飞[2] 阎晓红[2] 

机构地区：[1]北京航空中心医院干部保健科,北京100020 [2]山东滨州医学院附属医院干部保健科,滨州256603

出　　处：《中国心血管杂志》2008年第3期184-187,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨血管紧张素Ⅱ1型受体(AT1)拮抗剂缬沙坦在治疗原发性高血压过程中对血清转化生长因子β1(TGF-β1)、基质金属蛋白酶-1(MMP-1)及其抑制剂(TIMP-1)水平的影响及其与逆转左心室肥厚(LVH)的关系。方法选择合并LVH的原发性高血压患者58例,给予缬沙坦治疗8个月,于治疗前后分别检测血中TGF-β1、MMP-1、TIMP-1水平及左心室重量指数(LVMI),进行对比分析。结果缬沙坦治疗后患者LVMI、血中TGF-β1水平较治疗前显著降低(均为P<0.01);MMP-1水平显著升高(P<0.05);TIMP-1水平有下降趋势,但与治疗前对比差异无统计学意义(P>0.05)。TGF-β1与MMP-1呈显著负相关(γ=-0.5571,P<0.01)。结论缬沙坦逆转原发性高血压患者左心室肥厚的作用可能与其降低TGF-β1、升高MMP-1水平有关;TGF-β1可能通过抑制MMP-1的表达来促进LVH的形成。Objective To investigate the influence of valsartan （angiotension Ⅱ type I receptor antagonist） on the levels of serum transforming growth factor-betal （TGF-β1）, matrix metalloproteinase-1 （MMP-1）, tissue inhibitors of metalloproteinase-1 （TIMP-1） in patients with essential hypertension （EH） and on reversing left ventricular hypertrophy （LVH）. Methods The 58 patients with EH and LVH identified by Dopple echocardiography were treated with valsartan. Before and after treatment for 6 months, left ventricle mass index （LVMI） and serum levels of TGF-β1, MMP-1, TIMP-1 were obtained and analyzed respectively. Serum levels of TGF-β1 and MMP-1 and TIMP-1 were measured by sandwich assay-enzyme linked immunosorbent assay （ELISA） and indirect-ELISA respectively. Results LVMI value of patients was significantly decreased after treatment with valsartan （P〈0. 01） , serum level of TGF-β1 was significantly decreased and level of MMP-1 was significantly increased correspondingly（P〈0. 01 and P〈0. 05 respectively）. Level of TGF-β1 was negatively correlated with level of MMP-I（γ=-0. 5571, P〈0.01）. Conclusions TGF-β1 may inhibit the expression of MMP-1 and cause LVH in patients with EH and valsartan reverses LVH possibly by decreasing the expression of TGF-β1 and increasing the level of MMP-1.

关 键 词：洛沙坦 高血压 肥大 左心室 

分 类 号：R541.3[医药卫生—心血管疾病]