血清胰岛素样生长因子-1与原发性高血压患者左心室肥厚和蛋白尿的关系

Relationship of insulin-like growth factor-1 to left ventricular hypertrophy and albuminuria in patients with essential hypertension

目的探讨血清胰岛素样生长因子-1(IGF-1)与原发性高血压(EH)患者心脏和肾脏损害的关系。方法选择51例EH患者和30例正常受试者,根据是否合并左心室肥厚(LVH)将EH病患者分为EH组和EH+LVH组,同时按不同血压等级分为3个组。用酶联免疫分析方法测定血清IGF-1水平,用散射比浊法测定尿白蛋白排泄率(UAER)。根据心脏超声各参数计算左心室质量指数(LVMI)。结果不同血压水平各组中,随着动脉血压水平的升高,血清IGF-1、LVMI、UAER均升高,组间差异有统计学意义;EH组血清IGF-1高于正常对照组(P<0.05),EH+LVH组血清IGF-1高于EH组(P<0.05),并显著高于正常对照组(P<0.01);EH组UAER显著高于正常对照组(P<0.01),EH+LVH组UAER显著高于正常对照组和EH组(P<0.01,P<0.01);血清IGF-1与LVMI、UAER均存在正相关性(r=0.41,P<0.05;r=0.53,P<0.05)。结论(1)循环血IGF-1水平与LVMI、UAER均密切相关,表明IGF-1参与了EH病的发生发展,并且很可能在EH心脏、肾脏损害的病理生理过程中起到了至关重要的作用。(2)EH病患者心脏、肾脏受损程度基本平行。

Objective To investigate the relationship of insulin-like growth factor-1（IGF-1） to left ventricular hypertrophy and microalbuminuria in patients with essential hypertension（EH）.Methods Thirty healthy individuals（as control） and 51 EH patients were included.EH patients were divided into EH group and EH with Left ventricular hypertrophy（LVH） group according to the left ventricular mass index（LVMI） measured by echocardiography.EH patients were also divided into 3 groups（mild,medium and severe） according to the level of blood pressure.The serum level of IGF-1was measured using enzyme-linked immunoassay and urinary albumin excretion rate（UAER） was assayed by ratenephelometry.Results IGF-1 level in EH patients was significantly higher than in control group（P〈0.05）,IGF-1 level was significantly higher in EH＋LVH group than in control and EH groups（P〈0.01 and P〈0.05,respectively）;UAER level in patients with EH was significantly higher than that in control group（P〈0.01）,UAER level was significantly higher in EH＋LVH group than in control group EH group both（P〈0.01,P〈0.01）.IGF-1 level had positive correlation with LVMI and UAER（r=0.41,P〈0.05;r=0.53,P〈0.05）.IGF-1 level,UAER and LVMI increased with the increase of blood pressure.Conclusions IGF-1 is positively correlated to LVMI and UAER.It is supposed to be involved in the pathophysiological process of EH and play an important role in the impairment of heart and kidney function in EH patient.The impairment of heart and kidney are in parallel in EH patients.