血清胶原代谢指标在评价高血压左室重构中的作用

Evaluation of left ventricle remodeling in the patients with essential hypertension by serum collagen marker

目的探讨高血压患者血清胶原代谢指标的变化及临床意义。方法按 WHO(1999年)高血压诊断标准选择原发性高血压患者94例,其中左室肥厚组(EH-LVH)41例、非左室肥厚组(EH-NLVH)53例;对照组32例。用放射免疫分析法测定血清Ⅰ型前胶原羧基端肽(PICP)、Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、层粘连蛋白(LN)水平,同时应用超声背向散射积分(IBS)技术测定左室图像平均强度(AⅡ_1、AⅡ_2)、左室质量指数(LVMI),对上述各指标进行相关性分析。结果 EH-LVH 组 PICP、PCⅢ、LN、HA 水平高于 EH-NLVH 组和对照组;EH-NLVH 组上述指标水平亦高于对照组。3组左室 IBS 参数 AⅡ_1、AⅡ_2间差异均有显著性。PⅠCP、PCⅢ、LN 均与 AⅡ_1、AⅡ_2和 LVMI 呈正相关。结论 PⅠCP、PCⅢ、LN 和 HA 可反映高血压患者胶原代谢异常,并对评价左室重构有一定作用。

Objective To investigate the clinical significance of changes of serum procollagen level in patients with essential hypertension （EH）. Methods Total 94 EH patients, including 41 EH patients with left ventricular hypertrophy （ EH-LVH）, and 53 without left ventricular hypertrophy （EH-NLVH） and 32 normotensive control subjects. The serum level of carboxyterminal propeptide of type Ⅰ procollagen （ PⅠCP）, procollagen type Ⅲ（PCⅢ）, laminin （LN） and hyaluronic acid （HA） were measured by radioimmunoassay method. Average image intensity of left ventricle （ AⅡ1, AⅡ2 ） and left ventricular mass index （LVMI） were measured by integrated backscatter （IBS）. Results The serum level of PⅠCP, PCⅢ, LN and HA in both EH-LVH group, EH-NLVH group was higher than control group, and also AⅡ1, AⅡ2 in 3 groups had significant difference. PⅠCP, PCⅢ and LN correlated with AⅡ1, AⅡ2 and LVMI. Conclusion The increased serum PICP, PCⅢ, LN and HA demonstrated the abnormal collagen metabolism in EH and played a certain role in evaluating the remolding of left ventricle.