盐敏感性高血压前列环素与血栓皖素A_2代谢异常及与早期肾损害的相关性研究  

Altered metabolism of TXA_2/PGI_2 as related to early kidney injury in patients with salt-sensitive hypertension.

作　　者：卢荔红[1] 陈慧[1] 骆杰伟[2] 吴小盈[1] 俞玲[1] 

机构地区：[1]福建医科大学省立临床医学院福建省心血管病研究所心内科,福州350001 [2]福建省立医院中医科,福州350001

出　　处：《中国实用内科杂志》2011年第4期291-293,共3页Chinese Journal of Practical Internal Medicine

基　　金：福建省自然科学基金重点资助项目(C0420003)

摘　　要：目的探讨急性口服盐水负荷对高血压盐敏感者肾脏前列环素(PGI2)及血栓皖素A2(TXA2)的代谢变化及其与早期肾损害的相关性。方法采用改良的Sullivan s法将2006—2009年福建省心血管病研究所心内科150例高血压患者分为盐敏感性(SS,83例)和非盐敏感性(NSS,67例)高血压组;采用放射免疫法测定尿白蛋白(Alb)及盐水负荷前后TXA2、PGI2的代谢产物TXB2、6-酮-PGF1α并对二者行相关分析。结果 SS组晨尿Alb/肌酐(Scr)显著高于NSS组,差异有统计学意义(P<0.05),口服盐水负荷后2 h,盐敏感者6-酮-PGF1α浓度明显较盐不敏感者低(P<0.05);而盐负荷后盐敏感者TXB2浓度、TXB2/6-酮-PGF1α及负荷后的增加幅度均明显较盐不敏感者高,TXB2/6-酮-PGF1α盐负荷后2 h显著,差异有统计学意义(P<0.05)。TXB2/6-酮-PGF1α与尿Alb/Scr呈显著正相关(r=0.267,P<0.05)。结论盐负荷对高血压盐敏感及盐不敏感者肾脏TXA/PGI代谢的影响有明显差异,与盐敏感性高血压早期肾损害有关。Objective To investigate the effects of acute oral saline load on metabolism of of thromboxane A2 （TXA2 ）/prostaglandin 12 （PGI2 ） as related to early kidney injury in salt-sensitive hypertensive patients. Methods 150 patients with essential hypertension registered to Fujian Medical University Provincial Clinical Hospital between 2006 and 2009 were divided into the salt-sensitive （ SS, n = 83 ） and non-salt-sensitive （ NSS, n = 67 ） groups based on modified Sullivan＇s method. Radioimmunoassay was used to measure the level of urine albumin （ ALB）, and levels of TXB2 and 6-keto-PGF1a （ metabolites of TXA2 and PGI2 ） before and after acute oral saline loading in the patients. Results The value of ALB/Cr in first morning urine of SS patients was higher compared with NSS patients ,with statistical difference noted （P 〈 0. 05 ）. At 2 hours after acute oral saline loading, the levels of 6-keto-PGF1a were lowered in SS hypertensive patients than in NSS ones （P 〈0. 05）. The levels of TXB2, TXB2/PGF1 and the increase of TXB2 and TXB2/PGF1a from baseline after saline loading were greater in SS group than those in NSS group. Statistical difference in the levels TXBa/PGF1a was shown at two hour after saline loading. The TXB2/PGF1a positively correlated with the levels of urine ALB/Cr in SS patients. Conclusion Saline loading produces significantly different effects on renal metabolism of TXA2 and PGI2 in between SS and NSS hypertensive patients. The altered metabolism of TXA2/PGI2 may be related to early kidney injury in salt-sensitive hypertension.

关 键 词：盐敏感性高血压 尿微量白蛋白 前列环素I2 血栓皖素A2 

分 类 号：R5[医药卫生—内科学]