摘要
目的:观察高血压左室肥厚患者心肌纤维化的血清学指标变化和血管紧张素转换酶抑制剂、钙拮抗剂对左室肥厚的逆转作用,探讨血清学指标作为临床判断左室肥厚与逆转的临床价值。方法:高血压左室肥厚组41例,高血压不伴左室肥厚组30例及正常对照组40名,对高血压左室肥厚组患者应用卡托普利和硝苯地平治疗24周,用超声心动图测定左心室重量指数(LVMI),用放射免疫分析法测定血清指标PCⅢ(Ⅲ型前胶原)、LN(层粘连蛋白)、HA(透明质酸)。并将LVMI与上述各参数作相关分析。结果:高血压左室肥厚组较高血压不伴左室肥厚组和正常对照组的血清PCⅢ、LN、HA含量明显增高(P<0.01),治疗后血清PCⅢ、LN、HA明显下降(P<0.01),PCⅢ、LN、HA均与LVMI呈显著正相关。结论:血清PCⅢ、LN、HA可以作为高血压左室肥厚患者心肌纤维化的观察指标。
Objective: To investigate values of serum myofibrosis markers in essential hypertensive patients and the reversive effect of ACEI and CCBA on left ventricular hypertrophy. Methods: Two dimensional echocardiography was performed to determine left ventricular mass index (LVMI). Serum precollagen type Ⅲ (PC Ⅲ) ,laminin(LN) and hyaluronic acid(HA) were measured by RIA in blood samples from 41 essential hypertensive patients with left ventricular hypertrophy (LVH) ,30 essential hypertensive patients without LVH and 40 healthy subjects. Hypertensive patients with LVH were treated with captopril and nifedipine for 24 weeks. The correlations between LVMI and the above parameters were analyzed. Results: Serum PC Ⅲ ,LN and HA were significantly increased (P<0.01) in hypertensive patients with LVH as compared with those without LVH and heaethy subjects. Serum PC Ⅲ , LN and HA were significantly decreased after tret-ment (P<0.01). Seram PC Ⅲ, LN and HA correlated positively with LVMI in hypertensive patients. Conclusions; The results suggest that PC Ⅲ , LN and HA may act as serum markers for myofibrosis cordis in hypertensive patients with LVH.
关键词
高血压
左心室肥大
逆转
心肌纤维化
Hypertension Left ventricle hypertrophy Reversion Myofibrosis cordis
