高血压左室肥厚与循环血胰岛素样生长因子-1和一氧化氮水平相关性的研究

Relationship between left ventricular hypertrophy induced by hypertension and the levels of insulin- like growth factor- 1 and nitric oxide

目的:观察原发性高血压(EH)患者循环血胰岛素样生长因子-1(IGF-1)和一氧化氮(NO)水平的改变,探讨它们在高血压左心室肥厚(LVH)发生发展中的作用。方法:采用放射免疫分析法(RIA)和硝酸还原酶法检测50例EH患者犤EH组,其中LVH20例(LVH亚组),非LVH30例(非LVH亚组)犦和30名健康人血清IGF-1和NO水平,并对结果进行相关分析。结果:EH组血清IGF-1明显高于正常对照组(P<0.01),NO明显低于正常对照组(P<0.01);LVH亚组血清IGF-1明显高于非LVH亚组(P<0.01),NO显著低于非LVH亚组(P<0.01),且IGF-1与NO水平呈负相关(r=-0.435,P<0.05);左心室重量指数(LVMI)与IGF-1呈正相关(r=0.398,P<0.05),与NO呈负相关(r=-0.653,P<0.01)。LVH患者治疗后,血清IGF-1水平明显低于治疗前(P<0.05),NO水平明显高于治疗前(P<0.01)。结论:EH患者血清IGF-1水平明显升高,NO水平明显降低,合并LVH者更甚,IGF-1和NO两者失衡可能参与了EH及LVH形成的病理生理过程。

Objective To observe the changes of the levels of insulin-like growth factor-1 （IGF-1） and nitric oxide （NO） in the patients with essential hypertension （EH）, and to explore their effects on the occurrence and development of left ventfieular hypertrophy （LVH）. Methods 20 hypertensives with LVH（LVH group）, 30 hypertensives without LVH（none LVH group）, and 30 healthy volunteers（the control group） were included in the study. The serum IGF-1 and NO levels of these participants were detected by radioimmunoassay （RIA） and nitrate reductase test and the data were analysed. Results The serum IGF-1 levels in LVH and none LVH groups were significantly higher than that in the control group （P 〈 0. 01）, whereas the serum NO levels in LVH and none LVH groups were lower （ P 〈 0. 01）; The serum IGF-1 level in group was higher than that in none LVH group （ P 〈 0.01 ）, while the serum NO level in LVH group was lower （ P 〈 0. 01 ）. There was a negative correlation between IGF-1 and NO （ r = - 0. 435, P 〈 0. 05） . LVMI was positively correlated with IGF-1 （ r = 0. 398, P 〈 0.05） and negatively correlated with NO （ r = - 0. 653, P 〈 0.01 ）. The serum IGF-1 levels in 17 normotensives with LVH after anti-hypertensive therapy were significantly lower than those before the treatment （ P 〈 0. 05）, whereas the serum NO levels were higher （ P 〈 0.01 ）. Conclusions The level of serum IGF-1 is markedly increased and the NO level decreased in the patients with EH, especially in those with EH and LVH. The imbalance between IGF-1 and NO is probably involved in the pathophysiological process of the development of EH and LVH.