高血压病患者血清Ⅰ型前胶原羧基端肽水平升高的意义  

Significance of increased serum procollagen type I carboxy terminal peptide in essential hypertension

作　　者：刘承云[1] 杨群芳[1] 王琳[1] 张银环[1] 毛焕元[1] 朱天刚[1] 

机构地区：[1]武汉同济医科大学协和医院

出　　处：《中华心血管病杂志》1998年第6期450-452,共3页Chinese Journal of Cardiology

摘　　要：目的测定高血压病（ＥＨ）患者血清Ｉ型前胶原羧基端肽（ＰＩＰ）水平，探讨其临床意义。方法采用放射免疫分析方法测定４８例ＥＨ患者和３０例正常血压（ＮＨ）的健康人血清ＰＩＰ的水平，并用超声心动图测量左室解剖、舒缩功能参数。动态心电图（ＤＣＧ）记录ＥＨ组室性心律失常程度，并以Ｌｏｗｎｗｏｌｆ法分级。结果ＥＨ组血清ＰＩＰ浓度较对照组显著升高（６．９１±０．６２μｇ／Ｌｖｓ４．８±０．３８μｇ／Ｌ，Ｐ＜０．０１）。在ＥＨ并左室肥厚者，血清ＰＩＰ浓度与左室质量指数正相关（ＬＶＭＩ）（ｒ＝０．５１６３，Ｐ＜０．０５），与左室舒张功能呈负相关（ｒ＝－０．５７３４，Ｐ＜０．０５）。ＥＨ组Ｌｏｗｎｗｏｌｆ分级３级以上室性心律失常者血清ＰＩＰ水平较０～２级明显升高（７．２５±０．３７μｇ／Ｌｖｓ６．１１±０．５４μｇ／Ｌ，Ｐ＜０．０５）。结论ＥＨ患者可能有心肌局部Ｉ型胶原合成增加。Objectives To evaluate the clinical significance of serum procollagen type I carboxy terminal peptide (PIP) in patients with essential hypertension (EH). Methods The serum concentratin of PIP was measured by specific radioimmunoassay in EH patients ( n =48) and in normotensive control subjects (NH, n =30). Two diamensional, M mode and Doppler ultrasound recordings were obtained in every subject to determine serveral parameters of left ventricular anatomy and function. Ambulatory ECG monitoring was performed in EH patients to record the ventricular arrhythmias which were categorized according to Lown Wolf classification. Results Serum concentration of PIP was markedly higher in EH patients (6.91±0.62μg/L vs 4.8±0.38μg/L, P < 0.01 ) than in normal subjects (6.91±0.62μg/L vs 4.8±0.38μg/L, P < 0.01) and it was correlated positively with the left ventricular mass index (LVMI, r =0.5163, P <0.05) and negatively with the left ventricular diastolic function ( P <0.05) in EH patients with LV hypertrophy. The serum concentration of PIP was significantly higher ( r =-0.5734, P <0.05)in ventricular arrhythmic patients of>grade Ⅲ than that in those of grade 0～Ⅱ (7.25±0.37μg/l vs 6.11±0.54 μg/L, P <0.05).Conclusion The finding suggests that the synthesis of myocardial collagen type I may be abnormally increased in patient with EH, and thus serum PIP might be an indirect index of hypertensive myocardial fibrosis.

关 键 词：高血压 胶原 血清 PIP 测定 

分 类 号：R544.1[医药卫生—心血管疾病]