高血压患者运动试验中血压反应与血中微RNA表达的相关性  

Blood pressure responses during exercise test and its correlation with the expression of microRNAs in hypertension patients

作　　者：徐望[1] 熊潭玮 陈华[1] 李娟芬[1] 丁晓宇[1] 陈天然[1] 钱宗杰[1] 

机构地区：[1]桂林医学院附属医院心血管内科,广西桂林541000

出　　处：《上海医学》2017年第6期368-373,共6页Shanghai Medical Journal

基　　金：国家自然科学基金(81160489);广西自然科学基金(012GXNSFAA053080);广西医疗卫生适宜技术研究项目(S201407-02);广西高校科学技术研究项目(YB2014283)资助

摘　　要：目的探讨高血压患者运动试验中血压与靶器官的损伤,以及血浆和外周血单个核细胞(PBMC)中微RNA(miRNA)表达。方法筛选90例高血压患者,根据运动试验中患者血压升高水平,将其分为运动性高血压组(35例)和普通高血压组(55例),另选取20名普通健康人作为正常对照组。记录所有研究对象静息时、运动最大负荷时和运动停止后2、6、10min时的收缩压和舒张压,检测其亚临床靶器官损伤相关指标[左心室质量指数(LVMI)、颈动脉内中膜厚度(IMT)、估算的肾小球滤过率(eGFR)、尿微量白蛋白水平],并应用实时荧光定量PCR测定血浆和PBMC中miRNA(miRNA-145、miRNA-143、miRNA-21)的表达水平。结果3组运动最大负荷时和运动停止后2min时的收缩压和舒张压分别显著高于同组静息时(P值均<0.05),运动停止后6、10min时的收缩压和舒张压分别显著低于同组运动最大负荷时(P值均<0.05);收缩压变化幅度较舒张压明显。运动性高血压组的LVMI、颈动脉IMT、eGFR、尿微量白蛋白水平均显著高于正常对照组和普通高血压组(P值均<0.05)。普通高血压组和运动性高血压组血浆中miRNA-145表达水平均显著低于正常对照组(P值均<0.05),运动性高血压组血浆中miRNA-145表达水平显著低于普通高血压组(P<0.05);3组间血浆中miRNA-143表达水平的差异均无统计学意义(P值均>0.05);普通高血压组血浆中miRNA-21表达水平显著高于正常对照组和运动性高血压组(P值均<0.05)。普通高血压组和运动性高血压组PBMC中miRNA-145、miRNA-143表达水平均显著低于正常对照组(P值均<0.05),运动性高血压组PBMC中miRNA-145、miRNA-143表达水平均显著低于普通高血压组(P值均<0.05);普通高血压组和运动性高血压组PBMC中miRNA-21表达水平均显著高于正常对照组(P值均<0.05),运动性高血压组PBMC中miRNA-21表达水平显著低于普通高血压组(P<0.05)。结论运动性高血压可被视为评估�Objective To explore the correlation between blood pressure （BP） response in exercise testing in patients with subclinical target organ damage and expression of microRNA （miRNA） in plasma and peripheral blood mononuclear cells （PBMC） in hypertension patients. Methods According to blood pressure levels in exercise test, 90 hypertension patients were divided into exercise hypertension group （n=35） and common hypertension group （n = 55）. Meanwhile, 20 healthy subjects were assigned to normal control group. Systolic and diastolic blood pressures were recorded at rest, at the moment of maximum load movement, at 2, 6 and 10 minutes after exercise. Indicators relating to subclinical target organ damage, such as left ventricular mass index （LVMI）, carotid intima-media thickness （IMT）, estimated glomerular filtration rate （eGFR）, and microalbuminuria （mAlb） were detected. Expression of miRNAs （miRNA-145, miRNA-143, miRNA-21 ） in plasma and PBMC were detected by real-time quantitative polymerase chain reaction （PCR）. Results Systolic and diastolic blood pressures at the moment of maximum load movement and at 2 minutes after exercise were significantly higher than those at rest in the three groups （all P〈0. 05）, while systolic and diastolic blood pressures at 6 and 10 minutes after exercise were significantly lower than those at the moment of maximum load movement （all P〈0. 05） ; the amplitude of systolic pressure variation was more obvious than diastolic pressure. LVMI, IMT, eGFR and mAIb levels in exercise hypertension group were significantly higher than those in common hypertension group and normal control group （all P〈 0. 05）. The expression of miRNA-145 in plasma in hypertension groups was significantly lower than that in normal control group （both P〈0. 05）, and the expression in exercise hypertension group was significantly lower than that in common hypertension group （P〈0.05）. There was no significant difference in the expression of miRNA-143

关 键 词：高血压 运动试验 微RNA 血管平滑肌细胞 

分 类 号：R544.1[医药卫生—心血管疾病]