老年轻中度高血压患者血清内皮素-1、一氧化氮水平与左室重构的关系  

Relationship between remodeling of left ventricle and ET-1 and NO in elderly patients with mild and moderate hypertention

作　　者：祝河忠 陈佳娟 ZHU Hezhong;CHEN Jiajuan(Department of Gerontology,Shiyan City Taihe Hospital（The Affiliated Hospital of Hubei Medical College）,Hubei Province,Shiyan 442000,China)

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)老年医学科,442000

出　　处：《临床合理用药杂志》2018年第25期3-5,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察老年轻中度高血压患者血清内皮素-1(ET-1)、一氧化氮(NO)水平与左室重构的关系。方法将轻中度老年高血压患者160例依据超声心电图检查结果分为4组(正常结构组35例,向心性重构组45例,向心性肥厚组40例,离心性肥厚组40例);将另无高血压的健康人40例设为对照组。检测各组患者左室舒张末期内径(LVEDd)、左室收缩末期内径(LVEDs)、室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPWT)、左室射血分数(LVEF);检测各组一氧化氮(NO)、内皮素-1(ET-1)水平。结果与对照组比较,4个高血压组ET-1水平升高,NO水平降低,向心性肥厚组与离心性肥厚组变化更加明显,且变化幅度大于正常结构组及向心性重构组,差异均有统计学意义(P<0.05);向心性肥厚组与离心性肥厚组EF及NO水平比较差异无统计学意义(P>0.05);血浆ET-1水平与RWT、IVST、LVPWT及LVMI呈正相关(r分别为0.511、0.525、0.601、0.721,P均<0.05),与LVEF呈负相关(r=-0.630,P<0.05);血清NO水平与IVST、LVPWT、RWT、LVMI呈负相关(r分别为-0.508、-0.513、-0.612、-0.739,P均<0.05),与LVEF呈正相关(r=0.583,P<0.05)。结论老年轻中度高血压左室重构的患者血ET-1水平升高,NO水平降低,该变化与左室重构程度相关,检测ET-1、NO水平有助于发现高血压左室结构异常,干预ET-1、NO的表达可能会抑制左室重构,延缓高血压患者向心力衰竭的进展。Objective To explore the relationship between remodeling of left ventricle and ET-1 and NO in elderly patients with mild and moderate hypertention. Methods 160 patinets with mild and moderate hypertension were divided into four groups according to their echocardiography performance： normal geomety group 35 cases,concentric remodeling group 45 cases,concertic hypertrophy group 40 cases,eccentric hypertrophy group 40 cases; 50 healthy people without hypertion were enrolled as control group. Left ventricular end-diastolic diameter（ LVEDd）,left ventricular end-systolic diameter（ LVEDs）,interventricular septum thickness（ IVST）,left ventricular posterior wall end-diastolic thickness（ LVPWT）,left ventricular ejection fraction（ LVEF） were measured in each group; nitric oxide（ NO） and endothelin-1（ ET-1） levels were observed in each group.Results Compared with control group,the levels of ET-1 in four hypertension groups increased,and the levels of NO decreased,the changes in centripetal hypertrophy group and eccentric hypertrophy group were more obvious,and the change range was larger than that of normal structure group and centripetal remodeling group,the differences were statistically significant（ P 〈0. 05）; There was no significant difference in the levels of EF and NO between central hypertrophy group and eccentric hypertrophy group（ P〉 0. 05）. Plasma ET-1 level was positively correlated with RWT,IVST,LVPWT and LVMI（ r were0. 511,0. 525,0. 601,0. 721,P〈 0. 05）. Negative correlation with LVEF（ r =-0. 630,P〈 0. 05）; Serum NO levels were negatively correlated with IVST,LVPWT,RWT,and LVMI（ r were-0. 508,-0. 513,-0. 612,-0. 739,and P 〈0. 05）,positive correlation with LVEF（ r = 0. 583,P 〈0. 05）. Conclusion The ET-1 level is rised in elderly remodeling of left ventricle patients with mild and moderate hypertention,but the level of NO is decreased; the chance could reflect the remodeling of left ventricle＇s level. So detecte the level of ET-1 and NO can make

关 键 词：高血压 左心室重构 血清内皮素-1 一氧化氮 

分 类 号：R544.1[医药卫生—心血管疾病]