CAJ | 학술논문

目的旨在探讨原发性高血压并肾功能损害早期患者双侧肾内动脉血流动力学改变与血浆神经肽Y(N P Y)、神经降压素(NT)水平变化的相关性.方法将90例轻、中度原发性高血压患者,根据血α1-微球蛋白,血、尿β2-微球蛋白水平将他们分为肾损害早期高血压组45例和无肾损害高血压组45例,采用双抗体夹心ELISA法对各组对象血浆NPY、NT水平进行测定,并同时用彩色超声多谱勒技术监测双肾叶段动脉(SRA)、叶间动脉(IRA)的收缩期峰速度(Vs)、舒张期末血流速度(Vd)、平均血流速度(Vm)、血流峰速加速时间(AT)、脉冲指数(PI)、阻力指数(RI).结果(1)肾损害早期高血压组与无肾损害组比较, SRA、IRA的Vs、Vd、Vm显著降低(p<0.05),AT明显延长(p<0.05),PI和RI明显增高(p<0.05).(2)肾损害早期高血压组与无肾损害高血压组比较,血浆NPY水平明显增高(p<0.01),NT显著降低(p<0.05).直线相关分析,NPY与Vs、Vd、Vm负相关(p<0.001),与PI、RI、AT正相关(P<0.001)；NT与PI、RI、AT负相关(P<0.01),与Vs、Vd、Vm正相关(p<0.001).结论原发性高血压肾损害早期患者肾内动脉血流动力学及血浆血管活性肽存在变化,血管活性肽与肾内动脉血流动力学存在相关性,血管活性肽可能在原发性高血压肾损害早期发挥重要作用.
목적지재탐토원발성고혈압병신공능손해조기환자쌍측신내동맥혈류동역학개변여혈장신경태Y(N P Y)、신경강압소(NT)수평변화적상관성.방법장90례경、중도원발성고혈압환자,근거혈α1-미구단백,혈、뇨β2-미구단백수평장타문분위신손해조기고혈압조45례화무신손해고혈압조45례,채용쌍항체협심ELISA법대각조대상혈장NPY、NT수평진행측정,병동시용채색초성다보륵기술감측쌍신협단동맥(SRA)、협간동맥(IRA)적수축기봉속도(Vs)、서장기말혈류속도(Vd)、평균혈류속도(Vm)、혈류봉속가속시간(AT)、맥충지수(PI)、조력지수(RI).결과(1)신손해조기고혈압조여무신손해조비교, SRA、IRA적Vs、Vd、Vm현저강저(p<0.05),AT명현연장(p<0.05),PI화RI명현증고(p<0.05).(2)신손해조기고혈압조여무신손해고혈압조비교,혈장NPY수평명현증고(p<0.01),NT현저강저(p<0.05).직선상관분석,NPY여Vs、Vd、Vm부상관(p<0.001),여PI、RI、AT정상관(P<0.001)；NT여PI、RI、AT부상관(P<0.01),여Vs、Vd、Vm정상관(p<0.001).결론원발성고혈압신손해조기환자신내동맥혈류동역학급혈장혈관활성태존재변화,혈관활성태여신내동맥혈류동역학존재상관성,혈관활성태가능재원발성고혈압신손해조기발휘중요작용.
Objective: To study the relationship between the change ofhemodynamics of both sides intrarenal arterial and the levels of NPY and NT in plasma of the essentialhypertensive patients(EH).Methods:90 patients withmild tomoderate EH weredivided into EH patients with early renaldamaged and EH patients without early renaldamagedgroups according to the level of blood α1-microglobulin,β2-microglobulin andUrineβ2-microglobulin (n1=n2=45).Vs, Vd, Vm, AT, PI and RI of both sides of SRA and IRA weremeasured by Colordoppler echocardiography while the levels of NPY and NT in plasma weremeasured by enzyme linked immunoscorbent assay (ELISA).Results:(1) Compared with the EH patients without early renaldamagedgroup, Vs, Vm and Vd of both sides of SRA and IRA in the EH patients with early renaldamagedgroup were significantly lower(p<0.05), AT were significantly prolonged(p<0.05) and PI, RI werehighter(p<0.05).(2) The levers of NPY in plasma of thegroup of EH patients with early renaldamaged were significantlyhighter (p<0.01) and NT were significantly lower (p<0.05) than thegroup of EH patients without early renaldamaged, There were significantly negative correlation between NPY and Vs, Vd, Vm;between NT and PI, RI, AT; There were significantly positive correlation between NPY and PI, RI, AT;between NT and Vs, Vd, Vm.Conclusions:Compared with the EH patients with early renaldamaged,hemodynamics of intrarenal arterial and levels of NPY and NThad obvious changed in EH patients with early renaldamaged.Hemodynamics of intrarenal arterial wasdeeply related to NPY and NT,NPY and NTmighthave effects in EH patients with early renaldamaged.