血浆神经肽Y神经降压肽水平与高血压患者血压昼夜变化和靶器官损害的研究

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目的通过观察血浆中神经肽Y(NPY)、神经降压肽(NT)水平的变化,探讨其对原发性高血压(EH)患者24H血压昼夜变化和靶器官损害影响的临床意义。方法对EH患者90例,对照组30例行24H动态血压监测,采用放射免疫分析法(RIA)在不同时间点(2:00,8:00,16:00)分别测定血浆NPY、NT含量;同时检测其心、脑、肾靶器官功能。结果(1)根据动态血压监测的结果将EH者分为杓型组与非杓型组。(2)EH患者各时间点血浆NPY水平均明显高于对照组(P<0·01),而NT水平低于对照组(P<0·05)。(3)与杓型组相比,非杓型组NPY水平在各时间点升高和NT水平降低更为明显,尤其在夜间2:00时更为显著,差异均有统计学意义(P<0·01)。(4)与无靶器官受损组相比,EH伴心、脑、肾靶器官损害的患者血浆NPY升高,而血浆NT水平明显降低(P<0·01);血浆NPY、NT在各靶器官损害患者之间差异无统计学意义。结论血浆NPY、NT水平昼夜变化可能是导致EH患者血压昼夜节律紊乱的原因之一。EH患者伴靶器官损害时,血浆NPY水平明显升高和NT水平降低不仅参与了EH的发生、发展,也参与了靶器官受损的过程。 Objective To investigate the clinical significance of the changes of neuropeptide Y (NPY) and neurotensin (NT) levels in plasma in patients with essential hypertension (EH) and the changes of diurnal changes of 24H blood pressure and target organ damage. Methods 90 cases of EH and 30 cases of control group were given 24H ambulatory blood pressure monitoring. Radioimmunoassay (RIA) was used to measure plasma NPY and NT contents at different time points (2: 00,8: 00,16: 00) At the same time test its heart, brain, kidney target organ function. Results (1) According to the results of ambulatory blood pressure monitoring, EH were divided into dipper group and non-dipper group. (2) Plasma NPY levels were significantly higher in EH patients at each time point than those in control group (P <0.01), while NT levels were lower than those in control group (P <0.05). (3) Compared with dipper group, the NPY level of non-dipper group increased more significantly at each time point and NT level decreased, especially at 2:00 PM, the differences were statistically significant (P < 0 · 01). (4) Compared with those without target organ damage, plasma NPY increased in patients with EH accompanied with heart, brain and kidney target organ damage while plasma NT level decreased significantly (P <0.01); NPY and NT in plasma There was no significant difference between the target organ damage patients. Conclusion The diurnal changes of plasma NPY and NT levels may be one of the reasons leading to the disorder of circadian rhythm of blood pressure in patients with EH. EH patients with target organ damage, plasma NPY levels were significantly elevated and NT levels are not only involved in the occurrence and development of EH, also involved in the process of target organ damage.
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