气体信号分子硫化氢与一氧化氮在高血压患者中的变化探讨

Effects of Plasma Hydrogen Sulfide and Nitric Oxide in Hypertensive Patients

目的：探讨气体信号分子硫化氢（H2S）及一氧化氮（NO）在高血压中的作用。方法：选择高血压患者262例，男性135例、女性127例，年龄25～70岁（57．81±12．66）岁。其中初发高血压患者67例（初发高血压组），经治高血压患者195例（经治高血压组）。经治高血压患者中，血压控制良好的患者38例、1级高血压水平68例，2级高血压水平64例、3级高血压水平25例。对上述患者中同时怀疑冠心病者进行冠状动脉造影术，病变冠状动脉≥1支并有70％以上狭窄的患者确定血压合并冠心病32例；并根据中国糖尿病诊断标准判断高血压合并糖尿病38例。同时选取正常对照组52例，男性31例、女性21例，年龄（55．52±14．23）岁。检测入选者的血浆H2S及NO浓度。结果：①血浆H2S在经治高血压组中明显低于正常对照组（P〈0．05）。②高血压合并冠心病及糖尿病患者的血浆H2S浓度均明显低于单纯高血压患者（P〈0．05）。③在经治高血压患者中，随着血压水平的增加，NO及H：S水平均逐渐降低。3级高血压水平患者的H2S及NO浓度均明显低于血压控制良好者（P〈0．05），而1级和2级高血压水平患者血浆NO、H2S与血压控制良好者比较均无显著性（P〉0．05）。结论：作为气体信号分子，H2S和NO在高血压的发生和发展中均具有重要作用。

Objective：The present study was designed to study the concentrations and effects of hydrogen sulfide（ H2S） and nitric oxide NO） in hypertensive patients. Methods ：A total of 262 essential hypertensive patients（57.81 ± 12. 66 years）were enrolled in this study. Sixty-seven had an recipient illness and 195 with confirmed essential hypertension had ever treated before. Thirty-eight patients had well controlled blood pressure ,68 had grade 1 hypertension ,64 had grade 2 hypertension and 25 had grade 3 hypertension. In hypertensive patients suspected with coronary heart disease or treated by coronary angiography, 32 also had coronary heart disease （CAD）. According to Chinese Diabetes Mellitus（DM） Diagnosis Standard,38 patients had DM. A total of 52 healthy,age- and sex-matched controls were also recruited. Plasma NO content and H2S concentration were determined in all patients and controls. Results ：①Compared with controls, plasma H2S level in the treated hypertensives was significantly lower （P 〈 0. 05 ）. ②Plasma H2S concentration in hypertensives with CAD and DM was lower than those in patients without CAD and DM（ P 〈0. 05 ）.③In the treated hypertensives ,plasma H2S and NO concentrations gradually decreased as blood pressure gradually increased, they were significantly lower than those in patients with well-controlled blood pressure（ P 〈 0. 05 ）. Conclusion：As signaling gasotransmitters, plasma H2S and NO might play important roles in the pathogenesis and development of hypertension.