高血压患者运动试验中血压反应与血中microRNAs表达的相关性研究

发布时间：2018-04-10 00:36

本文选题：高血压　切入点：运动试验　出处：《桂林医学院》2017年硕士论文

【摘要】：目的:探讨运动试验中血压变化与高血压患者靶器官的损伤与血浆及外周血单个核细胞(PBMC)中microRNAs表达的关系。方法:筛选90例高血压患者,根据运动试验中患者血压升高水平,将其分为运动性高血压组(55例)和普通高血压组(35例),另选取普通健康人20名作为正常对照组。记录所有患者静息时、运动最大负荷时和运动停止后2、6、10 min的收缩压和舒张压,检测其亚临床靶器官损伤相关指标[左心室质量指数(LVMI)、颈动脉内中膜厚度(IMT)、估算的肾小球滤过率(eGFR)、尿微量清蛋白水平],并应用实时荧光定量PCR测定血浆和PBMC中microRNA(microRNA-145、microRNA-143、microRNA-21)的表达水平。结果:3组运动最大负荷时和运动停止后2 min时的收缩压和舒张压分别显著高于同组静息时(P值均0.05),运动停止后6、10 min时的收缩压和舒张压分别显著低于同组运动最大负荷时(P值均0.05);收缩压变化幅度较舒张压明显。运动性高血压组的LVMI、颈动脉IMT、eGFR、尿微量白蛋白水平均显著高于正常对照组和普通高血压组(P值均0.05)。普通高血压组和运动性高血压组血浆中microRNA-145表达水平均显著低于正常对照组(P值均0.05),运动性高血压组血浆中microRNA-145表达水平显著低于普通高血压组(P0.05);3组间血浆中microRNA-143表达水平的差异均无统计学意义(P值均0.05),普通高血压组血浆中microRNA-21表达水平显著高于正常对照组和运动性高血压组(P值均0.05)。普通高血压组和运动性高血压组PBMC中microRNA-145、microRNA-143表达水平均显著低于正常对照组(P值均0.05),运动性高血压组PBMC中microRNA-145、microRNA-143表达水平均显著低于普通高血压组(P值均0.05);普通高血压组和运动性高血压组PBMC中microRNA-21表达水平均显著高于正常对照组(P值均0.05),运动性高血压组PBMC中micro RNA-21表达水平显著低于普通高血压(P0.05)。结论:运动性高血压可被视为评估靶器官损伤相关指标血压与靶器官损伤之间联系的一个重要因素,运动性高血压患者、普通高血压患者和健康人的血浆和PBMC中的microRNA表达存在差异。
[Abstract]:Aim: to investigate the relationship between changes of blood pressure in exercise test and target organ injury in patients with hypertension and the expression of microRNAs in plasma and peripheral blood mononuclear cells (PBMCs).Methods: 90 patients with hypertension were selected and divided into exercise hypertension group (55 cases) and normal hypertension group (35 cases) according to the elevated level of blood pressure in exercise test.Systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded in all patients at rest, at maximum exercise load and 2 minutes after exercise stoppage for 10 min.The subclinical target organ injury related indexes (left ventricular mass index (LVMI), carotid intima-media thickness (IMT), estimated glomerular filtration rate (GFR), urine microalbumin level) were measured. The expression of microRNA-145microRNA-143microRNA-21 in plasma and PBMC was measured by real-time fluorescence quantitative PCR.Results systolic blood pressure and diastolic blood pressure were significantly higher at maximum exercise load and 2 min after exercise cessation than at rest in the same group (P = 0.05). Systolic blood pressure and diastolic pressure at 6 minutes and 10 min after exercise cessation were significantly lower than those at exercise peak in the same group.At high load, P value was 0.05 and the change of systolic blood pressure was more obvious than that of diastolic pressure.LVMI, IMT IMT eGFR and urinary microalbumin levels in exercise induced hypertension group were significantly higher than those in normal control group and normal hypertension group (P < 0.05).The expression of microRNA-145 in plasma of normal hypertension group and exercise hypertension group was significantly lower than that of normal control group (P < 0.05), and that of exercise induced hypertension group was significantly lower than that of normal hypertension group (P 0.05). The expression of microRNA-143 in exercise induced hypertension group was significantly lower than that in normal hypertension group (P 0.05).There was no significant difference in the level of microRNA-21 between the two groups. The expression of microRNA-21 in the plasma of the normal hypertension group was significantly higher than that of the normal control group and the exercise induced hypertension group.The expression level of microRNA-145 microRNA-143 in PBMC in normal hypertension group and exercise hypertension group was significantly lower than that in normal control group (P < 0.05), and the expression level of microRNA-145 microRNA-143 in PBMC in exercise hypertension group was significantly lower than that in normal hypertension group (P < 0.05), while in normal hypertension group, the expression level of microRNA-145 microRNA-143 was significantly lower than that in normal hypertension group (P < 0.05).The expression of microRNA-21 in PBMC and exercise induced hypertension group was significantly higher than that in normal control group (P < 0.05). The expression of micro RNA-21 in PBMC in exercise induced hypertension group was significantly lower than that in normal hypertension group (P 0.05).Conclusion: exercise induced hypertension can be regarded as an important factor in evaluating the relationship between blood pressure and target organ injury.The expression of microRNA in plasma and PBMC was different between normal hypertension patients and healthy people.
【学位授予单位】：桂林医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

【参考文献】