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目的:探讨原发性高血压(EH)患者血清醛固酮(PAC)和Ⅲ型前胶原氨基端肽(PⅢNP)水平与左室几何构型的关系。方法:采用放射免疫法测定EH组(118例)血浆PAC和PⅢNP浓度;根据心脏彩色超声检测结果,依照左室重量指数(LVMI)、相对室壁厚度(RWT)将118例EH患者分为正常构型亚组(22例)、向心性重构亚组(29例)、离心性肥厚亚组(31例)、向心性肥厚亚组(36例)。应用相关性分析了解EH组LVMI、RWT、年龄、血压、体质指数(BMI)、左室射血分数(LVEF)等因素与PAC、PⅢNP关系。结果:在EH各构型亚组中,向心性肥厚亚组、离心性肥厚亚组PAC、PⅢNP水平较对照组升高,且向心性肥厚亚组升高更明显。EH组PAC、PⅢNP与RWT呈正相关(r=0.402,r=0.507 P<0.01),与LVMI呈负相关(r=-0.202;r=-0.307,P<0.05)。而年龄、血压、BMI与LVMI、RWT无明显相关性。结论:EH组中不同的左室几何构型对PAC和PⅢNP水平产生不同影响。PAC和PⅢNP参与EH患者左室几何构型的改变,在向心性肥厚亚组中升高明显。
Objective: To investigate the relationship between serum aldosterone (PAC) and type Ⅲ procollagen aminopeptidase (PⅢNP) and left ventricular geometric configuration in patients with essential hypertension (EH). Methods: Plasma PAC and PⅢNP levels were measured by radioimmunoassay in 118 EH patients. According to the results of color Doppler echocardiography, 118 EH patients were divided into two groups according to left ventricular mass index (LVMI) and relative wall thickness (RWT) (22 cases), concentric remodeling subgroup (29 cases), eccentric hypertrophy subgroup (31 cases) and concentric hypertrophy subgroup (36 cases). Correlation analysis was used to analyze the relationship between LVMI, RWT, age, blood pressure, body mass index (BMI), left ventricular ejection fraction (LVEF) and PAC, PⅢNP in EH group. Results: In all subtypes of EH, the levels of PAC and PⅢNP in centripetal hypertrophy subgroup and eccentric hypertrophy subgroup were higher than those in control group, and were more pronounced in subgroup of concentric hypertrophy. EH group PAC, PⅢNP and RWT was positively correlated (r = 0.402, r = 0.507 P <0.01), and LVMI was negatively correlated (r = -0.202; r = -0.307, P <0.05). Age, blood pressure, BMI and LVMI, RWT no significant correlation. CONCLUSIONS: Different left ventricular geometric configurations in the EH group have different effects on PAC and PIIINP levels. PAC and PⅢNP involved in the changes in left ventricular geometric configuration of patients with EH, in concentric hypertrophy subgroups increased significantly.