CAJ | 학술논문

目的：观察原发性高血压（EH）患者血清脂联素（APN）和可溶性细胞黏附分子1（sICAM-1）的水平变化，分析 APN 和 sICAM-1与 EH 左心室舒张功能变化之间的关系。方法采用酶联免疫吸附（ELISA）法测定高血压1级、2级、3级患者各41例、及35例正常对照者血清 APN 及 sICAM-1浓度，同时检测血糖、血脂、血尿常规等相关指标；并用超声心动图测量各组左心室舒张末期内径（LVEDd），左心室后壁厚度（LVPWT），舒张末期室间隔厚度（IVST），并计算左心室质量指数（LVMI ）。根据血流频谱测定二尖瓣瓣尖舒张早期最大血流速度（E 峰）、晚期最大血流速度（A 峰）并计算 E/A 比值。结果 EH 患者血清 APN 浓度（3．56±1．27）ng/L 低于正常对照组（4．98±1．12） ng/L（P ＜0．05），其中高血压1级患者血清 APN 水平（4．55±0．93）ng/L 显著高于高血压3级患者（2．62±0．96）ng/L（P ＜0．01）。EH 患者血清 sICAM-1浓度（6．10±1．89）μg/L 显著高于正常对照组（3．22±1．53）μg/L（P ＜0．01），且随高血压分级的升高而升高。相关分析显示 LVMI 与血清 APN 呈负相关（r ＝-0．448，P ＜0．01）， sICAM-1与血清 APN 呈负相关（r ＝-0．484，P ＜0．01）。结论血清 APN 及 sICAM-1可能参与高血压病理发展过程；监测两者浓度为临床评估高血压病变程度及预后提供了一项重要信息；LVMI 是影响血清 APN 水平的独立影响因素。
목적：관찰원발성고혈압（EH）환자혈청지련소（APN）화가용성세포점부분자1（sICAM-1）적수평변화，분석 APN 화 sICAM-1여 EH 좌심실서장공능변화지간적관계。방법채용매련면역흡부（ELISA）법측정고혈압1급、2급、3급환자각41례、급35례정상대조자혈청 APN 급 sICAM-1농도，동시검측혈당、혈지、혈뇨상규등상관지표；병용초성심동도측량각조좌심실서장말기내경（LVEDd），좌심실후벽후도（LVPWT），서장말기실간격후도（IVST），병계산좌심실질량지수（LVMI ）。근거혈류빈보측정이첨판판첨서장조기최대혈류속도（E 봉）、만기최대혈류속도（A 봉）병계산 E/A 비치。결과 EH 환자혈청 APN 농도（3．56±1．27）ng/L 저우정상대조조（4．98±1．12） ng/L（P ＜0．05），기중고혈압1급환자혈청 APN 수평（4．55±0．93）ng/L 현저고우고혈압3급환자（2．62±0．96）ng/L（P ＜0．01）。EH 환자혈청 sICAM-1농도（6．10±1．89）μg/L 현저고우정상대조조（3．22±1．53）μg/L（P ＜0．01），차수고혈압분급적승고이승고。상관분석현시 LVMI 여혈청 APN 정부상관（r ＝-0．448，P ＜0．01）， sICAM-1여혈청 APN 정부상관（r ＝-0．484，P ＜0．01）。결론혈청 APN 급 sICAM-1가능삼여고혈압병리발전과정；감측량자농도위림상평고고혈압병변정도급예후제공료일항중요신식；LVMI 시영향혈청 APN 수평적독립영향인소。
Objective To observe the change of serum adiponectin(APN)and soluble intercellular adhesion molecule-1(sICAM-1)in patients with essential hypertension(EH),and analyze the relationship of APN and sICAM-1 with EH left ventricular diastolic function.Methods By using the enzyme-linked immunosorbent assay(ELISA),we measured the concentration of serum APN and sICAM-1,and related indexes of blood glucose,blood lipid,blood and urine routine in patients with hypertension grades 1,2,and 3,in which each grade had 41 cases,and 35 normal controls;echocardiography was used to measure left ventricular end-diastolic diameter(LVEDd),left ventricular posterior wall thickness(LVPWT),end-diastolic chamber interval thickness(IVST)of each group,and calculated left ventricular mass index(LVMI).Doppler parameters were used to measure the blood flow in sharp early diastolic mitral flow velocity maximum(E),late Vmax(A)and calculate E/A ratio.Results Serum APN (3.56±1.27)ng/L in patients with EH was lower than that of normal control group (4.98 ± 1.22)ng/L(P < 0.05).Serum level of APN in patients with hypertension stage 1 (4.55±0.93)ng/L was significantly higher than that in patients with hypertension stage 3 (2.62 ± 0.96)ng/L (P < 0.01 ).The concentration of serum sICAM-1 in patients with EH (6.10 ± 1.89 )μg/L was significantly higher than that of normal control group (3.22±1.53)μg/L (P <0.01),and it rose with the increase of hypertension grade.Correlation analysis showed that LVMI was negatively correlated with serum APN (r =-0.448, P <0.01),and the serum sICAM-1 was negatively correlated with APN,as well(r =-0.484,P <0.01).Conclusion APN and sICAM-1 may be involved in the pathogenesis of hypertension; the monitor of the two markers concentration provides the most important information for the clinical evaluation of the degree and prognosis of hypertension;LVMI affects APN level as an independent factor.