非对称性二甲基精氨酸和肿瘤坏死因子对原发性高血压左心室构型的影响  

Effect of tumor necrosis factor-ca and asymmetric dimethylarginine on left ventricle of patients with primary hypertension.

作　　者：李鑫[1] 蔡久英[1] 

机构地区：[1]辽宁医学院附属第一医院心内科,锦州121001

出　　处：《中国综合临床》2010年第1期3-5,共3页Clinical Medicine of China

基　　金：辽宁省医药卫生科研基金资助项目（20060517）

摘　　要：目的观测正常人及高血压患者在不同左心室构型组血清中的肿瘤坏死因子α（TNF-α）和非对称性二甲基精氨酸（ADMA）浓度变化，并探讨TNF—α和ADMA在高血压心脏损害中的病理生理作用。方法选取体检健康人员30名为正常对照组。轻中度高血压患者66例，根据左心室质量指数（LVMI）和相对室壁厚度（RWT）将其分为4组，即正常左心室构型组：LVMI和RWT均正常；向心性构型组：LVMI正常，RWT增大；向心性肥厚型组：LVMI和RWT均增大；离心性肥厚型组：INMI增大，RWT正常。采用放射免疫法及反相高效液相色谱法分别测定各组血清中TNF-α及ADMA。结果对照组和以上4组中TNF-α分别为（11．86±2．45）、（22．08±4．67）、（25．88±5．36）、（32．54±5．63）、（48．72±8．86）ng/L；ADMA：（0．78±0．22）、（1．32±0．18）、（1．87±0．20）、（3．03±0．14）、（4．11±0．17）μmol／L。血清TNF-α和ADMA水平随左心室构型严重程度的增加而升高，左心室构型组患者均明显高于正常对照组（P均〈0．01），且左心室重构各亚组间两两比较差异均有统计学意义（P均〈0．01）。结论TNF—α和ADMA可能参与了高血压左心室构型的发生和发展。Objective To understand the level of tumor necrosis factor-α （TNF-α） and asymmetric dimethylarginine （ADMA） in serum of healthy adults and primary hypertension patients with different left ventricle,and to explore the role of TNF-α and ADMA in the pathophysiological mechanism of heart damage due to hypertension. Methods Thirty health adults were recruited as control. Based on the left ventricular mass index （LVMI）and relative wall thickness（RWT）,66 patients of hypertension were divided into 4 groups： normal left ventricle group with normal LVMI and RWT, concentric remolding group with normal LVMI and incremental RWT, typical concentric hypertrophy group with incremental LVMI and RWT, eccentric left ventricular group incremental LVMI and normal RWT. TNF-α was measured by radioimmunoassay and ADMA was measured through reversed phase high-performance liquid chromatography. Results TNF-α and ADMA increased with the severity of the left ventricle. Each left ventricle group was significantly higher than control group （ P 〈 0.01 ）. The differences between left ventricle groups were statistically significant （ P 〈 0.01 ）. Conclusions TNF-α and ADMA may participate in the development of left ventricle.

关 键 词：原发性高血压 心室重构 肿瘤坏死因子Α 非对称性二甲基精氨酸 

分 类 号：R544.1[医药卫生—心血管疾病]