肝细胞生长因子、血管紧张素Ⅱ水平与动态血压的关系

Study of the relationship between 24-hour ambulatory blood pressure and hepatocyte growth factor, angiotensin Ⅱ

目的探讨肝细胞生长因子(HGF:hepatocyte growth factor)、血管紧张素Ⅱ(AngⅡ:angiotensinⅡ)与高血压及血压昼夜节律性的关系。方法选择41例高血压病患者及19例正常血压者行24小时动态血压测定,分析HGF、AngⅡ与高血压及血压昼夜节律性的关系。比较不同高血压级别HGF、AngⅡ浓度;杓型及非杓型高血压患者HGF、AngⅡ浓度;HGF、AngⅡ与动态血压各指标的关系。分析HGF与AngⅡ之间的关系。结果EH组血浆AngⅡ、HGF较对照组明显升高,且随病程严重程度平行,差异有统计学意义。EH组中非杓型亚组血浆HGF、AngⅡ较杓型组高。非杓型高血压亚组中HGF与24hDBP、dDBP、nSBP、nDBP正相关,相关系数分别为0.553、0.592、0.627、0.487,P值分别为0.021、0.012、0.007、0.047;非杓型高血压亚组中AngⅡ与24hSBP、dSBP、nDBP正相关,相关系数分别为0.584、0.601、0.523;P值分别为0.014、0.011、0,030。HGF及AngⅡ与杓型高血压各参数无显著相关性。高血压组与对照组比较,血浆AngⅡ、HGF相关系数分别为0.562,0.143,P值分别为P<0.01,P=0.561。结论AngⅡ的升高是决定高血压的发生发展及高血压患者昼夜节律性的重要因素之一。HGF浓度高低可以反映昼夜节律消失导致内皮受损严重程度。高血压患者HGF的升高可能是一种代偿性保护反应。HGF可能可以作为ACEI或ARB类药物干预治疗疗效的一个重要指标。

Objective To study the relationship between ambulatory blood pressure and hepatocyte growth factor, angiotensin Ⅱ. Methods We investigated the relationship by measuring the serum HGF and AngⅡ concentration and performing 24-h ambulatory blood pressure monitoring in 60 randomly selected subjects. Results The serum HGF and AngⅡ levels in patients with EH were higher than those in control. The changes Of HGF and AngⅡ levels were related to the severity of disease. The Serum HGF and AngⅡ levels in the non-dipper sub-group were higher than those in The dipper sub-group. HGF concentration was positively correlated with 24hDBP、dDBP, nSBP and nDBP （r=0.553, P=0.021; r=0.592, P=0.012; r=0.627, P=0.007; r =0.487, P=0.047, respectively）. AngⅡ concentration was positively correlated with 24hSBP, dSBP and nDBP （r=0.584, P=0.014; r=0.601, P=0.011; r=0.523, P=0.030, respectively）. HGF concentration was positively correlated with AngⅡ concentration in EH group （r=0.562, P〈0.01）. Conclusions Ang Ⅱ may be the important cause of the hypertension and has effect on circadian rhythm of blood pressure in EH. The results also indicated that there is a relationship between blood pressure measured by ABPM and serum HGF or Ang Ⅱ concentration, HGF might be evaluated as a possible biochemical index of damage of endothelial cells due to hypertension.