原发性高血压患者血浆神经肽Y的变化

Alteration of Plasma Neuropeptide Y in Patients with Essential Hypertension

目的通过观察血浆神经肽Y(NPY)在原发性高血压(EH)患者中浓度的变化,探讨血浆NPY在EH病理生理进程中的作用及在EH靶器管损害中的意义。方法选EH患者115例,以左室肥厚、脑卒中与肾功能损害为靶器官损害,其中伴有左室肥厚者21例,伴有脑卒中者13例、伴有肾功能损害者11例,为单一靶器官损害组,伴有两种或两种以上靶器官损害者19例为联合靶器官损害组,余下51例为单纯高血压而无靶器官损害组,体检健康者30例为对照组。取空腹静脉血用放射免疫方法测定NPY的血浆浓度。结果1)EH患者血浆NPY浓度高于对照组(P<0.01),不同血压级别之间血浆NPY浓度亦存在显著性差异(F=76.717,P<0.01),且随着血压级别的上升而升高。血浆NPY浓度与平均动脉压呈正相关(r=0.86,P<0.01)。2)单一靶器官损害组血浆NPY浓度高于单纯高血压而无靶器官损害组,差异有非常显著意义(P<0.01)。联合靶器官损害组血浆NPY浓度高于单纯高血压而无靶器官损害组,差异有非常显著意义,而与单一靶器官损害组相比差异无统计学意义(P>0.05)。结论血浆NPY可能与EH的病理生理进程以及EH靶器官损害的发生和发展有关,检测血浆NPY浓度可作为评价EH进程及靶器官损害程度的指标。

Objective To observe the change of plasma neuropeptide Y（NPY） concentration in patients with essential hypertension, and its relevance to target organ damage. Methods The plasma NPY concentration was determined by radioimmunoassay（RIA） in 115 patients with essential hypertension, including 45 patients with single target damage （left ventricle hypertrophy 21, stroke 13, nephropathy 11 ） and 19 patients with multiple target damage, with 30 normal as controls. Results 1） Plasma NPY concentration in patients with essential hypertension was significantly higher than normal controls （P〈0.01 ）, which was commensurately increase with the grades of hypertension （F= 76. 717, P〈0.01 ）. Plasma NPY concentration was positively related with mean artery pressure（r= 0.86, P〈0. 01 ）. 2 ） Plasma NPY concentration in patients with target organ damage was significantly higher than patients without target organ damage（P all〈0.01 ）, NPY in patients with multiple target organs damage was higher versus patients without target organ damage（ P〈0. 01 ）, while in patients with multiple target organ damage and with single target organ damage, NPY is no difference （P〉0.05）. Conclusion NPY may involve in the physiopathologic progress of essential hypertension and associate with the development of target organ damage. Evaluation of plasma NPY concentration may be valuable biomarker in estimation the severity of hypertension and target organ damage.