钠/锂反转运及尿血管舒缓素与少年儿童高血压

Erythrocyte Sodium lithium Countertransport and Urinary Kallikrein Excretion in Children with Hypertension

在一组年龄 10～ 15岁血压偏高及血压正常少年儿童 5年血压等随访的基础上 ,进行红细胞膜钠 /锂反转运、尿血管舒缓素及盐敏感性等测定。发现血压偏高及高血压家族史阳性少年儿童红细胞膜钠 /锂反转运速率显著增高 ,尿血管舒缓素排泄水平降低 ,且与血压及盐敏感性相关 ;钠 /锂反转运偏高或尿血管舒缓素偏低者过去 5年中血压上升幅度显著增大 ,其收缩压百分位数 (PSBP)多数上升或持续居于较高百分位次。提示红细胞膜钠 /锂反转运增强及尿血管舒缓素排泄低下作为高血压中间表现型 ,参与血压调节 。

Based on a 5 year follow up of blood pressure(BP),the red cell sodium lithium countertransport(Na\++/Li\++CT) rate and over night urinary kallikrein(Ukal) excretion were measured in a group of children aged 10～15 yrs.The sodium sensitivity (SS) was also estimated by oral saline load and furosemide sodium volume depletion.Total of 300 children were enrolled in this study.The results showed that in the children with high blood pressure(HBP) and those with family history of hypertension(FH\++),the Na\++/Li\++CT rate was significantly higher,and the Ukal excretion was much lower than those in the controls (P<0.01);the Na\++/Li\++ CT rate and Ukal excretion were correlated with BP and salt sensibility.In the 5 year retrospective review of the BP evolution,it was found that the increased extent of BP (ΔSBP) in the children with higher Na\++/Li\++ CT rate and with lower Ukal excretion was much greater than that in the controls (P<0.01).In the former the systolic blood pressure(P\-\{SBP\}) mostly kept rising or on higher percentiles in this period. We believe that the increased Na\++/Li\++ CT rate and the decreased Ukal excretion can serve as the intermediate phenotype of essential hypertension,participating in the regulation of BP and development of hypertension in the childhood.