肾上腺髓质素2与原发性高血压靶器官损害的关系  

Relationship between Adrenomedulin 2 and Target Organ Damage in Essential Hypertension

作　　者：罗晓佳[1] 陈晓平[1] 刘丽云[1] 曾建辉[1] 何森[1] 李龙兴[1] 

机构地区：[1]四川大学华西医院心内科,四川成都610041

出　　处：《中华高血压杂志》2010年第6期585-589,共5页Chinese Journal of Hypertension

摘　　要：目的观察原发性高血压靶器官损害患者肾上腺髓质素2(ADM2)变化。方法 2008-05-07参加华西医院健康体检的四川国光电器厂职工623例中,筛选出符合要求的受试者156例(男性90例,占57.7%,女性66例,占42.3%)参加研究,年龄(64.6±6.5)岁。所有受试者被分成3组,包括正常对照组(31例),高血压组(69例),高血压靶器官损害组(56例)(肾脏损害和左心室肥厚)。对受试者采集病史,体格检查,超声心动图评估左室质量指数(LVMI),采血检测生化指标,同时按照《MDRD方程在我国慢性肾脏病患者中的改良和评估》推荐的方程,计算肾小球滤过率(GFR)及用ELISA法测定ADM2。结果高血压靶器官损害组的ADM2高于高血压组和正常对照组[(1.96±0.49)>(1.23±0.45)>(0.69±0.24)μg/L,P<0.01]。相关性研究结果显示,LVMI与ADM2呈正相关(r=0.222,P=0.04),肌酐与ADM2呈正相关(r=0.532,P<0.01),GFR与ADM2呈负相关(r=-0.613,P<0.01)。Logistic回归分析显示ADM2与高血压靶器官损害具有相关性(OR45.697,95%CI13.021～160.368,P<0.01)。结论 ADM2可能作为高血压靶器官损害的预测因子。Objective To evaluate the relationship between the changes of adrenomedulin 2 and target organ damage in Han Chinese hypertensives. Methods Six hundred and twenty-three individuals from Guoguang Electric Factory participated in a health examination in 2008, of which 156 （female 42.3%, male 57.7% } appropriate sub- jects aged （64.6±6.5} years were selected, and were divided into three groups： the normal control group, the hy- pertensives group, hypertensive with target organ damage group. Physical examination and medical histories were collected, blood biochemical test and the adrenomedulin 2 was detected using ELISA, ultrasound cardiogram was performed. Results The hypertensives with target organ damage group had a significantly higher adrenomedulin 2 compared with other groups [{1.96±0.49）〉（1.23±0.45）〉（0.69±0.24）μg/L, P〈0.01]; Bivariate Correla- tions analysis showed that adrenomedulin 2 corelated with left ventricu-larm ass index（LVMI）, Glomerular Filtration Rate（ GFR） and creatinine significantly（ r= 0. 222, P= 0.04 ; r= - 0. 613, P〈0.01 ; r= 0. 532, P〈0.01 ） ; Multiva- riate logistic regression showed that adrenomedulin 2 was significantly associated with hypertensive target organ damage （OR 45. 697,95% CI 13.02]-160. 368, P〈0.01）. Conclusions adrenomedulin 2 may be used as a risk factor to predict the hypertensive target organ damage.

关 键 词：原发性高血压 肾上腺髓质素2 靶器官损害 肾小球滤过率 左心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病]