原发性高血压患者血清NO、NOS及其亚型水平的分析

Study on the Serum Levels of Nitric Oxide, Nitric Oxide Synthase and Its Subtypes in Patients with Essential Hypertension

目的:测定原发性高血压患者外周血中血清一氧化氮(NO)、一氧化氮合酶(NOS)及其亚型水平,探讨NO/NOS系统参与血压调节的可能机制。方法:原发性高血压患者135例,正常对照组35例。采用化学法检测所有病例外周血的一氧化氮(NO)、总NOS、诱导型一氧化氮合酶(iNOS)和结构型一氧化氮合酶(cNOS)水平并作统计学分析。结果:高血压组NO、NOS、iNOS和cNOS水平均低于正常对照组,且差异具有显著性意义(分别为:P<0.05,P<0.01,P<0.01,P<0.01);iNOS/cNOS比值与正常对照组相比无显著差异(P>0.05);对照组和高血压组的NOS浓度与iNOS和cNOS浓度均呈显著正相关;高血压组的cNOS水平与iNOS水平呈显著负相关。结论:高血压患者NO、NOS及其亚型浓度值可以作为临床评估高血压的参考指标;iNOS在正常人体内有表达;在高血压情况下,机体有通过增加iNOS的表达来弥补cNOS水平的病理性降低、调控NOS总体水平从而调节和平衡血压的趋势。

Objective To explore the possible role played by NO/NOS system in regulation of blood pressure through measurement of serum NO, NOS and its subtypes levels in patients with essential hypertension （EH）. Methods Serum NO, NOS, iNOS and cNOS levels were measured with colorimetry in 135 patients with essential hypertension and 35 controls. Results The serum levels of NO, NOS, iNOS and cNOS in patients with EH were all significantly lower than those in controls （ P 〈 0.05 or P 〈 0.01 ）. There was no significant difference between the iNOS/cNOS ratios in patients with EH and controls （ P 〉 0.05 ）. NOS levels in both groups were significantly positively correlated with the respective iNOS and cNOS levels. In patients with EH, the cNOS levels were negatively correlated with the iNOS levels. Conclusion Determination of the levels of serum NO, NOS and its subtypes could be helpful for clinical assessment in patients with EH. In controls, iNOS was expressed as well. In patients with EH, more iNOS was released in an effort to make up （ only imcompletely） the deficiency of cNOS to maintain a higher NOS level so that blood pressure could be heifer regulated.