原发性高血压患者循环中IGF-1水平与心肌肥厚的研究

Relation between myocardial hypertrophy and the circulating insulin-like growth factor-1 in patients with essential hypertension

目的:探讨原发性高血压(EH)患者循环中的胰岛素生长因子- 1(IGF - 1)与心肌肥厚的关系。方法:采取酶免疫分析方法测定5 3例为原发性高血压患者和16例正常人的血清IGF - 1水平。结果:发现原发性高血压患者循环中的IGF - 1水平显著高于正常组(P <0. 0 5 )。高血压病心肌肥厚组的血清IGF - 1水平显著高于非心肌肥厚组,2. 75 . 5±116 .4vs 2 0. 3 8±82 . 9,P <0 . 0 1。左室重量指数与血清IGF - 1存在相关性(r =0 .4 5 ,P <0 . 0 1)。从IGF - 1的水平可以看出在原发性高血压患病时间<15年的LVH患者IGF - 1升高明显,而原发性高血压患病时间(≥15年)IGF - 1水平有下降的趋势。以脉压≤6 0mmHg、>6 0mmHg划分为2个组,脉压≤6 0mmHg心肌肥厚有10人;脉压>6 0mmHg心肌肥厚有2 0人,占该组患者的6 .5 % ,2组比较P <0 . 0 5 ;2组的血清IGF - 1浓度无显著差异(P>0 .0 5 )。结论:①原发性高血压IGF - 1的升高,提示IGF - 1可能参与高血压某些病理生理过程。②高血压病心肌肥厚组的血清IGF - 1浓度的显著升高、左室重量指数与血清IGF - 1存在相关性,提示血清IGF - 1有促进心肌肥厚作用。③以患病时间长短来划分,血清IGF - 1在患病时间≥15年出现有意义降低。④脉压>6 0mmHg患心肌肥厚病人较多。

AIM: To investigate the relationship betw ee n circulating insulin-like growth factor-1 (IGF-1) and hypertension patients wit h left ventricular hypertrophy (LVH). METHODS: Serum IGF-1 concentrations in 53 patients with essentia l hypertension and 16 healthy persons were measured by enzyme immunoassay (EIA). RESULTS: The results showed that serum IGF-1 concentration in e ssential hypertension was significantly higher than that in non-hypertension. Se rum IGF-1 concentration in myocardial hypertrophy was significantly higher than that in myocardial non-hypertrophy (275.5±116.4 vs 203.8±82.9,P<0 .01). There was positive correlation between serum IGF-1 and LVMI (r=0.45) . 10 of 22 hypertension patients in pulse pressure ≤60 mmHg group were found to have myocardial hypertrophy, the ratio was 45%. Circulating IGF-1 concentration of patients with hypertension in suffering time ≥15 years is lower than that i n suffering time <15 years. 20 of 31 hypertension patients in pulse pressure >60 mmHg were found to have myocardial hypertrophy, the ratio was 65%. There was no significant difference in serum IGF-1 concentration between two groups. CONCLUSION: ①These results indicated that circulating IGF-1 con centration was increased in essential hypertension, suggesting that circulating IGF-1 participates in the pathophysiological process of essential hypertension . ②Serum IGF-1 concentration in myocardial hypertrophy was significantly higher than that in myocardial non-hypertrophy. There was positive correlation between serum IGF-1 and LVMI, indicating that serum IGF-1 may promote myocardial hypert rophy. ③According to the suffering time result, the circulating IGF-1 in hypert ens ion decreased significantly in the patients whose suffering time was less than 1 5 years. ④The hypertension patients with myocardial hypertrophy showed positive correlation with higher pulse pressure (>60 mmHg), indicating that the increase in pulse pressure participates in the course of myocardial hypertrophy. ⑤There was no significant correlation between pulse pressure and serum IGF-1 concentra tion, suggesting that different mechanisms are involved in the development of my ocardial hypertrophy between pulse pressure and IGF-1.