苯丙氨酸对高血压病患者后代的遗传性心脏改变的作用

Improvement of the pre-hypertensive inherited cardiac dearrangements with phenylalanine in essential hypertension

目的验证苯丙氨酸能否改善高血压病患者后代高血压病前期遗传性左心室肥大和收缩功能减低的改变。方法以５０名无高血压病家族史的正常青少年的超声心动图值为标准，在有高血压病家族史的青少年中筛选出有遗传性左心室肥大即室间隔及（或）左心室后壁≥１０．５ｍｍ者９６名，随机分为干预组（苯丙氨酸１ｇ／天，５８名）和对照组（安慰剂胶囊１ｇ／天，３８名），用双盲、交叉及对照观察，比较干预前和干预后３、６、９个月时的超声心动图变化。结果干预后升主动脉扩大和左心室肥大出现改善，在９个月时，两批的室间隔、左心室后壁及重量分别由干预前的１０．９±１．２降至９．２±０．６ｍｍ；９．５±１．０降至８．６±０．６ｍｍ；９２±１５降至７０±１１ｇ／ｍ２；收缩功能的参数值均升高。干预后心脏的改善和停止干预后的复原在６个月时很明显。结论在父或母患高血压病的子女所见的遗传性心脏异常可被认为是高血压病的前期改变，也可被一种天然必需氨基酸——苯丙氨酸所逆转，这一发现为早期预防高血压病拓开了新思路。

Objective To assess whether phenylalanine intervention can effectively improve the pre hypertensive inherited cardiac hypertrophy and systolic dysfunction in young offsprings of patients with essential hypertension(EH).Methods Ninty six normotensive adolescents with hypertensive family history and associated with inherited cardiac hypertorphy,i.e,interventricular,septum(IVST)and(or)left ventricular post wall thickness(PWT)≥10 5mm,were screened according to the normal range criteria of ultrasonic cardiogran(UCG)obtained previously from 50 normotensive adolescents without hypertensive genetic predisposition.The UCG parameters before and after3,6,9months of observation were compared between intervention group(Phe1g/d,58subjects)and placebo control group(placebo1g/d,38 subjects)in2separate trials by adouble blind,randomized,cross over and comparable placebo comtrol design.Results The hypertrophy and dilatation of ascending aorta and left heart structure were regressed after intervention,i.g,the changes after9months intervention,IVST dropped from10 9±1 2 to9 2±0 6mm,PWT from9 5±1 0to8 6±0 6mm,left ventricular mass index from92±15to70± 11g/m 2 ;All of the parameters reflecting the systolic function of left ventricle were improved in pooled group of2trials.The UCGs after placebo was fundamentally not changed except some sporadic values. The results were similar in2separate trials.The improvement after Phe and its return towards that of pre intervention after stope were remarked at6months.Conclusion The inherited cardiac dearrang ement seen in adolescents with hypertensive genetic predisposition can be assumed to be the pre hyperte nsive changes of EH.It can be reversed by phenylanlanine anatural and essential amino acid.