嗜铬粒蛋白A、儿茶酚抑素与原发性高血压及左室肥厚的关系

发布时间：2018-05-13 06:29

本文选题：儿茶酚抑素 + 嗜铬粒蛋白A　；参考：《皖南医学院》2017年硕士论文

【摘要】：目的:探讨血浆中人儿茶酚抑素(catestatin,CST)、嗜铬粒蛋白A(Chromogranin,CGA)水平与原发性高血压之间关联,及CST、CGA与原发性高血压患者左心室肥厚之间的关系。方法:选取71例原发性高血压患者(排除心力衰竭),男28例,女43例,平均年龄66.77±11.43岁。按照中国高血压防治指南血压水平分为高血压1级,高血压2级,高血压3级3组,另单独选取同期健康体检者30例,其中男15例,女15例,平均年龄62.23±8.51岁。原发性高血压患者登记既往血压最高值,健康者取体检时测定血压值,并测量所有受试者身高、体重、血常规、血生化、脑钠肽(Brain Natriuretic Peptide,BNP)等一般资料,同时测定空腹外周血中CST及CGA水平。并完善心超、心电图、胸片等相关检查。根据心超所测左室射血分数(LVEF)、舒张末期左室腔内径(LVIDd)、舒张末期室间隔厚度(interventricular septum thickness,IVST)、舒张末期左室后壁厚度(Left Ventricular Posterior Wall Thickness,LVPWT)等相关数据,求取左心室质量指数(LVMI),并采用脉冲多普勒分别测量二尖瓣舒张早期血流峰值速度(E峰),舒张晚期血流峰值速度(A峰),计算E/A值,分为E/A1及E/A1,应用spss19.0软件比较各组指标之间是否存在统计学差异。再将高血压组患者根据LVMI分为左室肥厚组和非左室肥厚组,统计分析各组间CST、CGA、LVMI等指标的差异。2结果:1.原发性高血压组外周血中CST水平较健康对照组水平明显降低(P0.05)。高血压并左心室肥厚组CST水平也明显低于高血压非左心室肥厚组及健康对照组。原发性高血压组外周血中CGA水平较健康组升高(P0.05),且在高血压并左心肥厚组也明显高于其他两组水平(P0.05)。2.线性相关分析结果示:外周血CST水平与SBP(r=-0.696,P0.05)、LVMI(r=-0.472,P0.05)呈负相关。CGA水平与SBP(r=0.483,P0.05)、LVMI(r=0.349,P0.05)呈正相关。外周血中CGA与CST浓度呈负相关(r=-0.681,P0.05)3.与健康组对比高血压组舒张功能明显受损,E/A值具有显著差异(P0.05),高血压组E/A1例数明显高于健康组。且随着患者血压水平升高,患者靶器官损害程度越重,高血压组LVMI较健康对照组明显增高(P0.05),但4组射血分数LVEF无明显差异(P0.05)。结论:1.原发性高血压患者外周血中儿茶酚抑素(CST)水平较健康者明显降低,且与血压增高水平呈负相关。2.原发性高血压患者外周血中嗜铬粒蛋白A(CGA)水平较健康者增高,与收缩压成正比。3.原发性高血压患者外周血中CGA、CST水平可反映靶器官左心室肥厚的严重程度,但尚不能作为预测左心室肥厚的独立危险因子。
[Abstract]:Aim: to investigate the relationship between plasma levels of human catechol-statin (CSTN), Chromogranin (CGA) and essential hypertension (EH), and between CST-CGA and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH). Methods: 71 patients with essential hypertension (male 28, female 43, mean age 66.77 卤11.43 years) were selected. According to the Chinese hypertension prevention and treatment guidelines, blood pressure was divided into 3 groups: hypertension grade 1, hypertension grade 2, hypertension grade 3, and 30 healthy persons were selected separately, including 15 males and 15 females, with an average age of 62.23 卤8.51 years. The highest value of blood pressure was registered in patients with essential hypertension, and the blood pressure was measured at the time of physical examination. The general data of height, weight, blood routine, blood biochemistry, brain natriuretic peptide (Brain Natriuretic Peptideus) and so on were measured. At the same time, the levels of CST and CGA in fasting peripheral blood were measured. And improve cardiac ultrasound, electrocardiogram, chest radiographs and other related examinations. According to the data of left ventricular ejection fraction (LVEF), left ventricular cavity diameter (LVIDdT), interventricular septum thickness-IVSTT, left ventricular posterior wall thickness (eft) and left ventricular posterior wall thickness (left ventricular posterior wall thickness) measured by echocardiography, left ventricular cavity diameter (LVIDdT) at the end of diastolic period, and interventricular septum thickness, etc. The left ventricular mass index (LVMIA) was obtained, and the peak velocity of mitral early diastolic and late diastolic peak velocities were measured by pulse Doppler, and the E / A value was calculated. Divided into E/A1 and E / A 1, spss19.0 software was used to compare whether there were statistical differences between each group. The patients in hypertension group were divided into left ventricular hypertrophy group and non-left ventricular hypertrophy group according to LVMI. The level of CST in peripheral blood of essential hypertension group was significantly lower than that of healthy control group. The level of CST in hypertension with left ventricular hypertrophy group was significantly lower than that in hypertension non-left ventricular hypertrophy group and healthy control group. The level of CGA in peripheral blood of essential hypertension group was higher than that of healthy group, and the level of CGA in hypertension with left ventricular hypertrophy group was significantly higher than that in other two groups. The results of linear correlation analysis showed that there was a negative correlation between the level of CST in peripheral blood and LVMIR r-0.472P 0.05 (P 0.05). There was a positive correlation between the level of CST and the level of CST. There was a negative correlation between CGA and CST in peripheral blood. Compared with the healthy group, the diastolic function in the hypertension group was significantly impaired and the E / A value was significantly different (P 0.05). The number of E/A1 in the hypertension group was significantly higher than that in the healthy group. With the increase of blood pressure, the degree of target organ damage was more serious, LVMI in hypertension group was significantly higher than that in healthy control group (P 0.05), but no significant difference in ejection fraction (LVEF) was found among the four groups. Conclusion 1. The levels of catechol-statin (CSTs) in peripheral blood of patients with essential hypertension were significantly lower than those of healthy subjects, and were negatively correlated with the increase of blood pressure. The level of chromogranin A CGA in peripheral blood of patients with essential hypertension was higher than that of healthy subjects, which was directly proportional to systolic blood pressure (SBP). The level of CGAN CST in peripheral blood of patients with essential hypertension can reflect the severity of left ventricular hypertrophy in target organs, but it can not be used as an independent risk factor for predicting left ventricular hypertrophy.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.11

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