硫化氢及一氧化氮气体信号分子在高原高血压发病中的作用

Pathophysiological significance of Hydrogen Sulfide and Nitric Oxide in High Altitude Hypertension

目的 探讨气体信号分子硫化氢（H2S）及一氧化氮（NO）在高原高血压的病理生理意义。方法 平原体检正常者进入海拔5000m高原（1～3）月期间，在高原暴露时间、劳动强度及生活条件相同的施工群体中随机抽样127人。依血压变化将其分为高原高血压（Ⅰ～Ⅲ级）组78人（进一步分为收缩期高原高血压组与舒张期高原高血压组），高原正常血压组49人，采取肘静脉血，采用敏感硫电极法测定其H2S浓度，Griess法测定血清NO含量。结果 高原高血压组、收缩期高原高血压组、舒张期高原高血压组的血清H2S与NO平均含量均显著增加，分别比正常血压组高34．5％，36．9％，31.7％（均P〈0．001）与28．4％，33．1％，39．7％，（均P〈0．05），尤以H2S更为突出；随着血压分级程度的升高H2S与NO血清含量相应增高，也以H2S更显著（R^2=0．918）；H2S与NO、舒张压间均有密切正相关关系及良好的拟和优度、与氧饱和度呈显著的负相关与拟和优度（R^2=0．374，P=0．001）。结论 H2S与NO的代谢失常可能参与了高原高血压发病过程。

Objective To investigate the significance of hydrogen sulfide（ H2S） and nitric oxide（ NO） in high altitude hypertension. Methods One hundred twenty-seven workers received healthy check-up before entering high altitude and worked at this circumstances （5 000 m above sea level）for 1 3 months. The living condition, intensity of work and the time of recovery in plateau were similar among them. Seventy-eight suffered from high altitude hypertension （ Ⅰ-Ⅲ grade） and 49 persons were in normal blood pressure. The serum content of H2S and NO were measured by sensitive sulphur electrode and Griess. Results As compared with normotensives, serum level of H2 S and NO evidently increased in high altitude hypertension（ 34.5% vs 28.4%, P 〈 0.05 ）, high SBP altitude hypertension （ 36.9% and 33. 1%, P 〈0.05）, and high DBP altitude hypertenslon（31.7% and 39.7%, P〈0.05）. The content of H2S and NO in blood was increased with the grades of BP especially for H2S（ R^2 =0. 918）, H2S and NO were closely re lated to DBP, while they are negatively related to O2 saturation（ R^2=0. 374, P= 0. 001）. Conclusion The metabolism of H2S and NO was associated with high altitude hypertension morbidity.