高血压病患者左室舒张功能变化与血清PIP水平关系的研究

Study of relations between left ventricular diastolic function and serum level of PIP in hypertensives

目的应用组织多普勒成像(TDI)技术评价高血压病患者左心室舒张功能变化,并探讨其与胶原代谢的血清标志物I型前胶原羧基端肽(PIP)水平之间关系。方法研究对象包括48例高血压病患者和30例健康对照者。采用双抗体夹心ABC-ELISA法测定血清PIP浓度,将研究对象分为三组:对照组(PIP<127μg/L,30例),高血压1组(PIP<127μg/L,32例)和高血压2组(PIP>127μg/L,16例)。应用TDI技术测量二尖瓣环舒张早期运动速度峰值(Ea)、舒张晚期运动速度峰值(Aa)并计算其比值(Ea/Aa)。结果高血压2组与高血压1组及对照组比较,Ea值降低,分别为(7.75±1.19)cm/s、(9.86±1.80)cm/s和(12.83±3.69)cm/s;Aa值增高,分别为(11.40±1.31)cm/s、(10.55±0.53)cm/s和(7.96±1.14)cm/s;高血压1组、高血压2组Ea、Aa值与对照组比较差异有显著性(P<0.01)。对照组、高血压1组、高血压2组Ea/Aa比值依次显著减小(1.40±0.39、0.88±0.23、0.68±0.17,P<0.01)。血清PIP水平与Ea/Aa比值呈显著负相关(r=-0.54,P<0.05)。结论高血压病患者血清PIP水平与左心室舒张功能受损程度有较好相关性,当PIP水平大于127μg/L时,左心室舒张功能受损更严重。因此,联合应用测定血清PIP水平与TDI技术检测左室舒张功能变化这两种无创方法,可用来评价高血压病患者心肌纤维化严重程度。

[Objective] To study the changes of diastolic function of left ventricle by Tissue Doppler Imaging （TDI） and analyse the relations between the diastolic function of left ventricle and the serum level of procollagen type Ⅰ C-terminal peptide （PIP） in patients with essential hypertension. [Methods] Forty-eight hypertensives and thirty healthy subjects were included in the study. The serum concentrations of PIP were measured by ABC-ELISA method. The subjects were divided into 3 groups： there were 30 healthy subjects with PIP 〈127 μg/L as control group, 32 hypertensives with PIP 〈127 μg/L as group 1, 16 hypertensives with PIP 〉127 μg/L as group 2. The early and late diastolic maximal myocardial velocity（Ea, Aa） and Ea/Aa of lateral wall motion of mitral valve annulus were measured and recorded by TDI. [Results] The Ea in group 2 was lower than that of group 1 and control group [（7.75±1.19） cm/s, （9.86±1.80） cm/s, （12.83±3.69） cm/s, respectively], and the Aa in group 2 was higher than that of group 1 and control group [（11.40±1.31） cm/s, （10.55±0.53） cm/s, （7.96±1.14） cm/s, respectively]; the-Ea and Aa in both group 1 and group 2 had statistic differences compared with those of control group （P 〈0.01）. The Ea/Aa decreased gradually in control group, group 1 and group 2 [（1.40±0.39）, （0.88±0.23）, （0.68±0.17）, P 〈0.01]. There was an correlation between the serum PIP level and Ea/Aa （r =-0.54, P 〈0.05）. [Conclusion] The decreased diastolic function of left ventricle assessed by TDI correlates with the serum PIP level in the patients with hypertension, when PIP 〉127 μg/L, the abnormalities of diastolic function of left ventricle are serious. Thus, the combination of these two methods may be useful for diagnosing the degree of myocardial fibrosis associated with hypertension.