老年原发性高血压患者外周血淋巴细胞β受体密度的变化及与心功能的关系

Changes of beta-adrenoceptor density of peripheral lymphocyte and its relationship with cardiac function in the elderly patients with essential hypertension

目的:观察各期老年原发性高血压患者外周血淋巴细胞β受体密度的变化特征及与心功能的关系,寻找进行药物及非药物干预的可能性。方法:选择老年高血压Ⅰ,Ⅱ,Ⅲ期患者(n=16,20,17)及正常体检老年人作为对照组(n=18),采用放射性配基结合法(125I-碘氰化心得静)分别测定其外周血淋巴细胞β受体密度。结果:①与对照组比较,各期患者外周血淋巴细胞β受体密度(pmol/g)分别为I期(7.02±2.58)无明显改变(t=0.32,P>0.05);Ⅱ期(12.76±3.24)显著增高(t=4.18,P<0.05);Ⅲ期(3.66±2.08)显著降低(t=3.75,P<0.05)。②原发性高血压Ⅱ期患者LVMI(g/m2)(196.5±39.6)较对照组(89.4±17.6)及I期患者(102.6±15.3)增高,差异有显著性意义(t=3.22,2.84;P均<0.01),与Ⅲ期患者(184.7±41.2)比较,差异无显著性意义(t=0.18,P>0.05)。③Ⅲ期患者E/A值(0.71±0.18)及射血分数(%)(38.4±7.83)较II期患者E/A(0.88±0.21)、射血分数(55.4±9.62)%降低,差异有显著性意义(t=2.04,2.26,P均<0.05)。结论:各期老年高血压患者外周血淋巴细胞β受体密度变化不同,β受体密度随心肌的肥厚有逐渐增加趋势,β受体密度降低则合并有心脏舒缩功能的明显下降。

AIM:To study the changing features of beta(β)-adrenoceptor density of peripheral lymphocyte of different stages of the elderly patients with essential hypertension(EH),so as to find out the probability of interventions with drug and without drug. METHODS:The radioactive ligand binding method(125I-ICYP) was used to examine the β-adrenoceptor density of peripheral lymphocyte of elderly EH patients of stage I(n=16),stage Ⅱ(n=20) and stage Ⅲ(n=17) and 18 normal elderly people. RESULTS:①In comparison of the β-adrenoceptor density (pmol/g) with the control group,there were no obvious changes in the stage I group(7.02±2.58,t=0.32,P >0.05),significant increases in the stage Ⅱgroup(12.76±3.24,t=4.18, P< 0.05) and significant decreases in the stage III group(3.66±2.08,t=3.75,P< 0.05).②The left ventricular mass index (LVMI, g/m2) in the stage Ⅱgroup(196.5±39.6) was significantly higher than those in the control group(89.4±17.6, t=3.22,P< 0.01) and stage I group(102.6±15.3,t=2.84, P< 0.01),but insignificantly different from that in the stage Ⅲgroup (184.7±41.2,t =0.18,P >0.05).③E/A and ejection fraction (EF) in the stage Ⅲgroup[(0.71±0.18), (38.4±7.83)%] were significantly lower than those in the stage II group [(0.88±0.21), (55.4±9.62)%] (t=2.04, 2.26,P< 0.05). CONCLUSION:There are differences in the β-adrenoceptor density changes in elderly EH patients of different stages,β-adrenoceptor density has an increasing tendency gradually with the thickening of myocardium,and its decrease is combined with obvious reduce of the diastolic and systolic functions of heart.