胰岛素样生长因子-1与高血压患者血压水平,心肌及血管重构的关系

Study on the association between insulin like growth factor-1 and blood pressure, myocardial remodeling, vascular remodeling in essential hypertension.

目的探讨高血压患者循环中胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)与其血压水平,心肌、血管重构之间的关系。方法55例高血压患者(高血压组)及15名体格检查正常者(正常对照组),采用ELISA测定血清IGF-1浓度。高血压组采用彩色多普勒超声测量室间隔厚度(in-terventricular septum thickness,IVS)、颈动脉内膜-中层厚度(intima-media thickness,IMT),计算左心室质量指数。结果①随着高血压级别的升高,血清IGF-1浓度逐步升高,其中高血压组2、3级组明显高于高血压1级组和正常对照组(均为P<0.05);②舒张末期室间隔厚度增厚组血清IGF-1浓度高于IVS正常组;左心室肥厚组血清IGF-1浓度高于非肥厚组(均为P<0.05);③IGF-1浓度与左心室质量指数呈正相关(r=0.46,P=0.001);④IMT和IVS呈正相关(r=0.49、P=0.03)。结论高血压患者的血清IGF-1水平与其血压程度以及心肌重构密切相关,与血管重构可能有一定关系;高血压患者的心肌、血管重构过程基本并行。

Objective： To investigate the association between serum insulin like growth factor-1 （ IGF-1 ） and blood pressure, myocardial and vascular remodeling in patients with essential hypertension. Methods： Fifty-five patients with essential hypertension （ hypertension group） and 15 normal person （ control group） were enrolled in this study. Serum IGF-1 was examined by enzyme-linked immunosorbent assay. Interventricular septum thickness （IVS） and carotid artery intima-media thickness （IMT） were measured by colour doppler echocardiography. Left ventricular mass index （LVMI） was calculated. Results： （1）IGF-1 concentration significantly increased in essential hypertension patients with grade Ⅱ and Ⅲ compared to hypertension grade Ⅰ and control group （ P 〈 0. 05 -0. 01 ） ; （2） IGF-1 concentration significantly increased in essential hypertension patients with increased IVS compared those with normal IVS （P 〈 0. 05 ）, IGF-1 concentration significantly increased in essential hypertension patients with left ventricular hypertrophy （LVH） compared those with non LVH （P〈0.05）; （3）IGF-1 concentration had positive correlation with LVMI （r = 0.46, P = 0. 001）, while IVS had positive correlation with IMT （r =0.49, P =0.03）. Conclusion： Serum IGF-1 is correlated to blood pressure and myocardial remodeling and may be correlated to vascular remodeling in essential hypertension. Myocardial and vascular remodeling is nearly parallel in essential hypertension.