高血压病患者红细胞膜磷脂与脂质过氧化、血液流变学关系的研究

A study on the correlation of erythrocyte membrane phospholipids with lipid peroxidation and blood rheology in patients with essential hypertension

我们观察了４５例高血压病（ＥＨ）患者红细胞膜磷脂，脂质过氧化及有关酶水平和血液流变各指标变化及相互关系。结果表明，ＥＨ患者红细胞膜磷脂中神经磷脂（ＳＭ）、磷脂酰胆碱（ＰＣ）、磷脂酰丝氨酸（ＰＳ）、神经磷脂与磷脂酰胆碱比值（ＳＭ／ＰＣ）和脂质过氧化物（ＬＰＯ）水平显著增高。磷脂酰乙醇胺（ＰＥ）、超氧化物歧化酶与脂质过氧化物比值（ＳＯＤ／ＬＰＯ）和谷胱甘肽过氧化物酶与脂质过氧化物比值（ＧＳＨ－ｐｘ／ＬＰＯ）则显著降低，血液流变各指标显著升高，经简单相关和多因素逐步回归分析表明：ＬＰＯ被选入ＳＭ、ＰＣ和ＰＥ回归方程，ＬＰＯ与ＰＣ、ＳＭ呈正相关，与ＰＥ呈负相关，提示ＬＰＯ对红细胞膜磷脂成分存在独立影响。红细胞膜磷脂中ＳＭ与全血粘度高切变率、ＰＳ与全血粘度低切变率呈正相关。因此，红细胞膜磷脂与血流变性和脂质过氧化之间存在某种联系，可能参与ＥＨ的发生和发展。

Abstract The changes and interrelation of erythrocyte membrane phospholipids (EPL), serum lipid peroxide (LPO) and related enzymes, and blood viscosity were studied in 45 cases of essential hypertension (EH) and 30 normal subjects. The results showed: The levels of sphingomyelin (SM), phosphatidyl serine (PS), phosphatidylcholine (PC),SM/PC of EPL and serum LPO of patients with EH were significantly higher than those of normals, but the values of phosphatidyl ethanolamine (PE), the ratio of superoxide dismutase (SOD) to LPO (SOD/LPO) and the ratio of glutathione peroxidase (GSH-PX) to LPO (GSH-Px/LPO) were lower. Blood viscosity significantly increased in patients with EH.Correlation and stepwise regression analyses showed:(1) Serum LPO positively correlated with SM,and negatively with PE, indicating that LPO exerted an independent influence on EPL. (2) SM positiveiy correlated with high shearing rate of whole blood viscosity and PS positively correlated with low shearing rate of whole blood viscosity.Therefore, there were certain connecxions among EPL, LPO and blood rheology,and might participate in the pathogenesis and progress of essential hypertension.