高血压伴高同型半胱氨酸血症对脉搏波传导速度的影响及相关机制的研究  

Effects of hypertension coupled with hyperhomocysteinemia on transmission of pulse wave velocity and possible related mechanism involved

作　　者：王清传[1] 张志敏 王元标[1] 杨敬霄 刘静 Wang Qingchuan;Zhang Zhimin;Wang Yuanbiao;Yang Jingxiao;Liu Jing(Internal Medicine,Military Institutional Hospital,Xinjiang Military Command,Urumchi 830000,Chin)

机构地区：[1]新疆军区机关医院内科,新疆维吾尔自治区乌鲁木齐830000 [2]空军军医大学唐都医院心内科

出　　处：《海军医学杂志》2018年第4期311-315,335,共6页Journal of Navy Medicine

基　　金：陕西省科学技术攻关课题(2010K 18-H1-6)

摘　　要：目的观察高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)对高血压患者脉搏波传导速度(pulse wave velocity,PWV)的影响,以及探讨其致病相关分子机制。方法收集原发性高血压患者58例为单纯高血压组,原发性高血压伴HHcy患者52例为H型高血压组,比较2组患者PWV。使用同型半胱氨酸(homocysteine,Hcy)3.0mmol/L干预人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)不同时间(0~12 h)。观察细胞活力、一氧化氮(nitric oxide,NO)释放浓度、葡萄糖调节蛋白78(glucose regulated protein 78 k D,GRP78)及含半胱氨酸的天冬氨酸蛋白水解酶(cysteinyl aspartate specific proteinase,caspase)-12表达水平。结果与单纯高血压组患者PWV(1 874.0±196.3)相比,H型高血压组患者PWV(2 318.0±224.5)明显升高(P<0.05)。与0 h组相比,Hcy 3.0 mmol/L干预HUVEC细胞6 h、9 h和12 h细胞活力降低,NO释放降低(P<0.05或P<0.01)。与0 h组相比,Hcy 3.0 mmol/L干预6 h、12 h GRP78表达明显升高(P<0.05或P<0.01);与0 h组相比,Hcy 3.0mmol/L干预6 h、12 h caspase-12表达均显著升高(P<0.05或P<0.01)。结论 HHcy可明显升高高血压患者的PWV,降低血管顺应性,影响血管功能;其分子机制之一可能是Hcy过度激活HUVEC细胞内质网应激(endoplasmic reticulum stress,ERS),使促凋亡因子caspase-12过表达,诱导细胞凋亡,导致细胞活力下降及NO释放减少,影响血管舒缩功能。Objective To observe the effects of hypertension coupled with hyperhomocysteinemia （HHcy）on transmission of pulse wave velocity （PWV） and possible related mechanism involved. Methods Fifty-eight patients with priulaty- hy-pertension were recruited as the simple hypertension group （or the HP group） and 52 patients with primapy hypertension and complicated hypertension with HHcy were designated as the H type hypertension group. Then, the values of pulse wave velocity- （PWV） were compared between the 2 groups. Human umbilical vein endothelial cells （ HUVEC ） at a dosage of 3.0 mmol/L were intervened at different time points （ 0- 12 h）. Then, cell viability, the expression levels of nitric oxide （ NO）, glucose regulated protein 78 （ GRP78 ） and cysteinyl aspartate specific proteinase 12 （ caspase-12 ） were closely observed and detected. Results Compared with the simple HP group （ 1 874.0 ± 196.3）, the level of PWV in the H ty-pe hy-pertension group （2 318.0 ±224.5）was significantly higher （P 〈0. 05）. Compared with that of the 0 h group, the cell viability- of the 6-h group, 9-h group and 12-h group was decreased respectively（P 〈 0.05 or P 〈 0.01 ） ,the levels of NO were respectively decreased（P 〈 0.05 or P 〈 0.01 ）. However, compared with that of the 0-h group, the expression of GRP78 was markedly increased at 6 h and 12 h（P 〈0.05 or P 〈 0.01）. Same as the above, the expression level of caspase-12 at 6 h and 12 h was also elevated considerably （P 〈 0.05 or P 〈 0.01 ）. Conclusion HHcy could significantly elevate the level of PWV in HP patients and decrease compliance and influence of blood vessels. One of the possible mechanisms might be that HHCY over-activa- ted endoplasmic reficulum stress（ERS） , promoted the over-expression of caspase-12, induced apoptosis of cells, decreased cell vibility and NO release, thus affecting the dilative function of vessels.

关 键 词：高同型半胱氨酸血症 高血压 脉搏波传导速度 人静脉脐细胞 内质网应激 

分 类 号：R544.1[医药卫生—心血管疾病]