论文部分内容阅读
目的:研究探讨原发性高血压心肌纤维化患者血清S100A4的意义,及天麻钩藤饮的调控作用。方法:纳入2013年8月至2015年2月本中心门诊确诊为原发性高血压患者112例,按照左心室质量指数(left ventricular mass index,LVMI)值将其分为非左室肥厚(non left ventricular hypertrophy,NLVH)组40例和左室肥厚(left ventricular hype Ircrophy,LVH)组72例;将LVH组患者72例随机分为开博通组35例,天麻钩藤饮37例。均给药4周,观察治疗前后各组患者血压和LVMI变化,及各组患者外周血清S100A4蛋白、血清透明质酸酶(HA)及和层粘连蛋白(LN)变化情况。结果:经治疗后3组患者收缩压、舒张压和LVMI较治疗前明显下降(P<0.01)。治疗前LVH组患者血清S100A4、HA、LN表达水平较NLVH组显著升高(P<0.05)。治疗4周后,LVH组中两组患者血清S100A4、HA、LN表达水平均较治疗前显著降低(P<0.05),与开博通组比较,天麻钩藤饮组血清S100A4、HA、LN表达显著降低(P<0.05);且血清S100A4表达与血清中HA、LN表达呈显著正相关。结论:S100A4可作为评估高血压心肌纤维化的有效指标,中药方剂天麻钩藤饮可通过降低S100A4水平进而阻止高血压心肌纤维化的发生发展。
Objective: To investigate the significance of serum S100A4 in patients with primary hypertensive myocardial fibrosis and the regulation of Tianma Gouteng Decoction. Methods: One hundred and twelve patients diagnosed as essential hypertension in our center from August 2013 to February 2015 were enrolled. According to left ventricular mass index (LVMI), they were divided into non-LV hypertrophy left ventricular hypertrophy (NLVH) group and left ventricular hypertrophy (LVH) group. Forty-two patients in the LVH group were randomly divided into Kai Boxung group (35 cases) and Tianma Gouteng decoction (37 cases). All patients were administered for 4 weeks. The changes of blood pressure and LVMI in each group before and after treatment were observed. The changes of S100A4, HA and LN in peripheral blood were also observed. Results: After treatment, systolic blood pressure, diastolic blood pressure and LVMI decreased significantly in all three groups (P <0.01). Serum levels of S100A4, HA and LN in LVH patients before treatment were significantly higher than those in NLVH patients (P <0.05). After 4 weeks of treatment, the levels of S100A4, HA and LN in two groups of patients in LVH group were significantly lower than those before treatment (P <0.05). Compared with Kaibutong group, the expression of S100A4, HA and LN in Tianma Goutengyin group (P <0.05). The expression of S100A4 in serum was positively correlated with the level of HA and LN in serum. Conclusion: S100A4 can be used as an effective indicator to evaluate myocardial fibrosis in hypertensive patients. Traditional Chinese medicine Tianma Gouteng Decoction can prevent the development of hypertensive myocardial fibrosis by decreasing S100A4 level.