原发性高血压左室肥厚患者妊娠相关血浆蛋白-A和C-反应蛋白的变化

Variations of pregnancy-associated plasma protein-A and C-reactive protein in essential hypertension patients with left ventricular hypertrophy

目的：探讨原发性高血压（EH）左室肥厚（LVH）患者血浆妊娠相关蛋白-A（pregnancy-associated plasma protein-A，PAPP-A）和C-反应蛋白（Creactive protein，CRP）的变化。方法：EH患者49例，行心脏彩色超声检查，测量室间隔厚度（IVST）、左室后壁厚度（LVPWT）及左室舒张末内径（LVDD），计算左室质量指数（LVMI）。根据LVH的诊断标准将EH患者分为LVH＋组和LVH一组。运用双抗体夹心酶联免疫吸附实验（EALAS法）测定血浆PAPP-A浓度和运用双抗体放射免疫法检测血浆高敏CRP（hs-CRP）浓度。结果：LVH＋组PAPP—A及hs-CRP均高于LVH-组[分别为8．28（5．90～30．91）mIU／L vs 4．39（3．02～6．98）n1IU／L和8．58（0．90～35．80）mg／L vs 1．90（0．50～2．23）mg／L，P均〈0．05J。PAPP-A与LVMI及hs-CRP与LVMI的相关分析显示：PAPP-A与LVMI呈显著正相关（r=0．649，P〈0．05），hs-CRP与LVMI呈显著正相关（r=0．441，P〈0．05）。结论：EH伴LVH患者PAPP-A及CRP较LVH-组显著升高，并且PAPP-A、hs-CRP与LVMI呈显著正相关。PAPP—A与CRP可能参与EH患者LVH的形成。PAPP—A与CRP可能是EH患者合并LVH的预测指标。

AIM： To investigate the variation of pregnancy-associated plasma protein-A （PAPP-A） and C-reactive protein （CRP） in essential hypertension （EH） patients with left ventricular hypertrophy（LVH）. METHODS： 49 patients with EH were examined by echocardiography to measure the inter-ventricular septurn thickness （IVST）, left ventricular posterior wall thickness（LVPWT） and left ventricular diastolic diameter（LVDD）, and to calculate the left ventricular mass index （LVMI）. The patients were divided into the left ventricular hypertrophy （LVH） group and the non-LVH group according to the diagnostic criteria of left ventricular hypertrophy . The levels of PPAP-A were detected by double-antibody sandwich enzyme-linked immunosorbent assay （ELISA） and the levels of hs-CRP were performed by double antibody radioimmunoassay. RESULTS： The levels of PAPP-A and hs-CRP were higher in the LVH group than the non-LVH [ 8.28（5.90 ± 30.91） mlU/L vs 4.39 （3.02 ± 6.98） mlU/L, 8.58 （0.90 ± 35.8） mg/L vs 1.90 （0.50 ± 2.23） mg/L, P all 〈 0.051. The relevant analysis showed that PAPP-A and LVMI were significantly correlated （ r = 0.649, P 〈 0.05） ; hs-CRP and LVMI were significantly correlated （ r = 0.441, P 〈 0.05）. CONCLUSION： The levels of PAPP-A and hs-CRP were higher in the LVH group than those in the non- LVH group. PAPP-A and LVMI are positively correlated, hs-CRP and LVMI are also positively correlated. PAPP-A and CRP may be involved in the formation of LVH in patients with EH. PAPP-A and CRP may be as predictors of the EH patients with LVH.