原发性高血压病人血浆中HCY、ADM和CGRP浓度测定的意义

Changes in Plasma HCY,ADM and CGRP in Patients with Essential Hypertension and Their Roles in Its Pathogenesis

目的通过测定原发性高血压病人血浆同型半胱氨酸(homocysteine HCY)、肾上腺髓质素(adrenomedullin ADM)、降钙素基因相关肽(CGRP)活性物质的水平,探讨血管活性物质与原发性高血压的关系,为原发性高血压的预防和治疗提供理论依据。方法随机选取未经治疗的原发性高血压病人42例作为研究组,按高血压分级标准分为3个亚组,,对照组选择20例同期健康体检的正常人。采受试者空腹静脉血,用荧光法定量检测HCY,用放射免疫法检测ADM和CGRP。结果(1)研究组血浆HCY、ADM浓度明显高于对照组,而CGRP水平明显下降,有显著统计学差异(P均<0.01)。(2)研究组三个亚组1级组、2级组和3级组HCY、ADM水平随着血压升高而升高,组间差别有统计学意义(P<0.01)。(3)研究组血浆HCY与ADM浓度呈正相关(r=0.941,P<0.01),与CGRP呈负相关(r=-0.480,P<0.01)。结论研究组血浆HCY、ADM水平明显升高,且血压越高,浓度越高,而CGRP水平随着血压的升高却明显降低;研究组HCY、CGRP水平变化,提示它们参与了高血压的发生与发展;ADM继发性升高,可阻止高血压进一步发展,对机体具有保护作用。

Objective To detect the levels of plasma homocysteine （HCY）, adrenomedullin （ADM）, calcitonin gene-related peptide （CGRP） in essential hypertension （EH） patients, investigate whether they are involved in the pathogenesis of EH, and provide the theoretic basis for its prevention. Methods A total of 42 EH patients without taking medication were randomly enrolled in study group which was divided into three subgroups, and another 20 healthy volunteers were enrolled in control group. The level d plasma HCY was measured by means of fluorometric method while the levels of ADM and CGRP were determined by radioimmunoassay. Results （ 1 ） The levels of plasma HCY and ADM in the study group were higher than those of the control group, whereas the level of plasma CGRP was lower （ P 〈 0.01 ）. （2） The levels of HCY and ADM in class I, class II and class III subgroups increased along with the ascension of the blood.pressure, and there were statistical differences between any two of the subgroups （P 〈 0.01 ）. （ 3 ） In the study group plasma HCY was positively correlated with ADM （ r = 0. 941, P 〈 0.01 ）, but negatively correlated with CGRP （ r = - 0.480, P 〈 0.01 ）. Conclusion In Eli patients, the concentrations of plasma HCY and ADM increase and are positively correlated with the level of blood pressure; the concentration of plasma CGRP decreases and is negatively correlated with the level of blood pressure. The changes in plasma HCY and CGRP level in EH patients suggest that they are involved in the pathogenesis and the development of hypertension. The secondary advance of ADM can inhibit the growth of hypertension and provide a protective effect on their bodies.