血清胰岛素样生长因子-1和一氧化氮水平与原发性高血压关系的临床研究

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目的探讨血清胰岛素样生长因子-1(IGF-1)及一氧化氮(NO)水平与原发性高血压(EH)及左心室肥厚(LVH)的关系。方法入选EH患者100例,为初次尚未服药治疗或服药后但血压控制不满意者,分为1、2、3级,计算左心室重量指数(LVMI),LVMI>125 g/m2(男)或>120 g/m2(女),为LVH。分为LVH(46例)组和无LVH(54例)组。另40例健康体检者作为对照组。分别用放射免疫法测定血清IGF-1及硝酸还原酶法测定血清NO水平。100例EH患者降压治疗3月后再次测定血压与血清IGF-1水平。结果 EH患者血清IGF-1水平(358.6±52.6)ng/ml高于正常对照组(142.5±41.3)ng/ml,血清NO水平(41.5±23.7)μmol/L低于对照组(82.1±20.8)μmol/L。EH组血压1~3级间血清IGF-1的水平(分别为257.6±45.3、329.4±32.8、412.3±41.5 ng/ml)随着EH级数的增加而增加且不同级数之间差异有统计学意义,NO的水平(分别为63.4±15.2、48.5±19.8、32.5±21.6μmol/L)随着EH级数的增加而降低且不同级数之间差异有统计学意义。EH伴LVH者血清IGF-1水平(387.4±35.8)ng/ml高于无LVH者(296.6±40.2)ng/ml,血清NO水平(34.3±18.2)μmol/L低于无LVH者(57.9±22.2)μmol/L。EH组经药物治疗3月后血压达标者的血清IGF-1水平(259.2±42.6)ng/ml低于血压未达标者(324.6±37.2)ng/ml,血清NO水平(75.6±12.9)μmol/L高于血压未达标者(46.2±15.3)μmol/L。结论 EH患者IGF-1升高,NO降低,可能参与高血压LVH的调节。其水平可以较好地反映LVH的程度。 Objective To investigate the relationship between serum levels of insulin-like growth factor-1 (IGF-1) and nitric oxide (NO) and essential hypertension (EH) and left ventricular hypertrophy (LVH) Methods One hundred and two patients with EH were enrolled in this study. One hundred and two patients were enrolled in this study. They were initially treated with or without medication and were not satisfied with their blood pressure control. They were divided into two groups 1, 2 and 3 and their left ventricular mass index (LVMI), LVMI> 125 g / > 120 g / m2 (female) for LVH. Divided into LVH (46 cases) group and no LVH (54 cases) group. Another 40 cases of healthy people as a control group. Serum NO levels were measured by radioimmunoassay with serum IGF-1 and nitrate reductase. Blood pressure and serum IGF-1 levels were measured again in 100 patients with EH after 3 months of antihypertensive treatment. Results The level of serum IGF-1 in EH patients was significantly higher than that in controls (358.6 ± 52.6) ng / ml (142.5 ± 41.3) ng / ml, while the level of NO in serum was lower than that in controls (41.5 ± 23.7 μmol / L, 82.1 ± 20.8) μmol / L. The levels of serum IGF-1 in EH group between the first and third grades of blood pressure (257.6 ± 45.3,329.4 ± 32.8 and 412.3 ± 41.5 ng / ml, respectively) increased with the increase of EH series, and there was statistical difference between different series Significance, NO level (63.4 ± 15.2,48.5 ± 19.8,32.5 ± 21.6μmol / L, respectively) decreased with the increase of EH series and the difference between different series was statistically significant. The levels of serum IGF-1 in EH patients with LVH were higher than those without LVH (387.4 ± 35.8) ng / ml (296.6 ± 40.2) ng / ml, while those in patients without EH accompanied by LVH were lower than those without LVH 22.2) μmol / L. The level of serum IGF-1 (259.2 ± 42.6) ng / ml was lower in the EH group than those in the non-compliance group (324.6 ± 37.2) ng / ml and the serum NO level (75.6 ± 12.9) μmol / L higher than those who did not meet the blood pressure (46.2 ± 15.3) μmol / L. Conclusion EH patients with elevated IGF-1, NO decreased, may be involved in the regulation of hypertension LVH. Its level can better reflect the degree of LVH.
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