原发性高血压患者的血浆硫化氢浓度变化

The Relationship Between Hydrogen Sulfide Plasmas And Essential Hypertensive in Han Chinese Patients

背景硫化氢(hydrogen sulfide,H2S)是一新型气体信号分子,具有直接舒张血管,抑制血管平滑肌细胞增殖,减轻血管炎症反应,促进血管新生等血管调节作用,在心血管疾病的发生发展中起了重要作用,如动脉粥样硬化、肺动脉高压、阿霉素心肌病等,但目前与高血压有关的研究并不多。目的通过测定原发性高血压(essential hypertension,EH)组和正常对照组血浆H2S浓度,并与相关临床资料进行比较分析,以探讨H2S和EH的相关性。方法入选上海瑞金医院高血压科住院患者83例,及瑞金医院体检中心同期健康体检人员120例。用比色法测定血浆H2S浓度,并用SPSS13.0软件对实验结果和相关临床数据进行统计分析。结果EH组血浆H2S浓度显著低于对照组(P=0.025)。血浆H2S浓度和年龄呈负相关(r=-0.321,P<0.01),年龄是影响EH患者血浆H2S的浓度的独立危险因素(B=-0.368,P<0.01)。EH组中,血浆H2S浓度和病程、颈动脉内膜-中膜厚度(intima-media thickness,IMT)呈负相关(病程:r=-0.329,P<0.01;IMT:r=-0.327,P<0.01),有脑卒史的EH患者其血浆H2S浓度显著低于无脑卒中史的EH患者(P<0.05),在Logistic回归分析中发现,血浆H2S浓度每降低1个标准差,EH患者脑卒中的患病风险增加14.7%。结论血浆H2S浓度可能反应了高血压血管损伤的程度,将来H2S能否作为一种血管损伤标志用于临床尚待进一步研究。

Background Hydrogen sulfide(H2S),as anovel gas signal molecule, plays a role invascular regulationviarelaxing blood vessels directly, inhibiting the smooth muscle cell proliferation, reducing the extracellular matrix and inflammation, promoting the angiogenesis of the blood vessels. Therefore, H2S is regarded as a logical candidate for deciphering the pathogenesis of cardiovascular disease, including atherosclerosis,pulmonaryhypertension, adriamycin-induced cardiomyopathy and so on. However, a literature search has not revealed many convincing evidences linking H2S to hypertension.Objective To investigate the relationship between H2S and essential hypertension(EH), and determine the plasma H2S concentrations between EH patients andcontrol group before and after considering relevant clinical indexes.Methods Total 83 hospitalized patients and 120 health controls were recruited from the Shanghai Ruijin Hospital. The Plasma H2S concentrations were determined by colorimetric method. Data were managed and analyzed using SPSS software for Windows (version 13.0). Results The plasma H2S concentrationsin EH group were significantly lower than those in the control group (P = 0.025), and were inversely correlated with the patients’ ages (r = -0.321,P< 0.01). Moreover, age is an independent risk factor for the effect of the plasma H2S concentrationson EH patients(B = -0.368,P< 0.01).In EH group, the plasma H2S concentrations and the courses, carotid intima-media thicknesses(IMTs) were both inversely related (for course:r = -0.329,P< 0.01; for IMT: r = -0.327,P < 0.01), and the plasma H2S concentrations of the patients with a history of stroke were significantly lower than those without (P< 0.05).By logisticregression analysis, we found that the risk of having stroke was increased by 14.7% with an decrease of plasma H2S levelsby one standard deviation.Conclusion Our results demonstrated that plasma H2S levels might reflect the degree of vascular injury of the hypertensive. For clinical practice, future studies should concentrate on the application of H2S in vascular injury.