正常高值血压患者血清脂质过氧化水平变化及其意义

Serum Lipid Peroxidation Levels in Patients with Pre-hypertension

目的观察正常高值血压(PH)患者血清脂质过氧化水平的变化,探讨其在高血压治疗和预防方面的意义。方法按照JNC7诊断标准筛选出PH患者106例,原发性高血压(EH)患者91例,同时随机挑选血压正常健康人(NT)98例作为对照。采用生化法测定血清中超氧化物歧化酶(SOD),谷胱甘肽过氧化物酶(GSH-PX),丙二醛(MDA),过氧化脂质(LPO)的含量。结果PH组患者血中总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)及体质量指数(BMI)明显高于NT组(P<0.05或0.01)。PH组和EH组血清MDA、LPO明显高于NT组[MDA,PH组(13.8±2.2),EH组(18.9±2.0)比NT组(10.5±1.3)μmol/L,分别为P<0.05和P<0.01];[LPO,PH组(2.4±0.4),EH组(2.8±0.4)比NT组(1.9±0.2)μmol/L,分别为P<0.05和P<0.01]。PH组血清GSH-PX明显高于NT组,EH组却明显低于NT组[GSH-PX,PH组(0.22±0.04)比NT组(0.20±0.03)μmol/L,P<0.05;EH组(0.18±0.04)比NT组(0.20±0.03)μmol/L,P<0.05]。PH组和EH组血清SOD都较NT组低[SOD,PH组:(72.4±10.7)、EH组:(65.1±10.0)比NT组(79.0±10.2)U/mL,分别为P<0.05和P<0.01];多因素logistic回归分析,正常高值血压与BMI、GSH-PX、MDA、LPO呈正相关(β为0.496、1.768、1.565、1.204;分别为P<0.05、P<0.05、P<0.01、P<0.01)。正常高值血压与SOD呈负相关(β为-0.115,P<0.05)。结论正常高值血压患者血清SOD下降、GSH-PX上升、MDA、LPO等过氧化产物增高,提示正常高值血压患者体内氧化应激增强。

Objective To study oxidative stress in prehypertensive（PH） patients. Methods One hundred and six PH patients and 91 essential hypertensive（EH） patients by JNC 7 were recruited, 98 normotensive（NT） subjects were served as controls. The levels of superoxide dismutase （ SOD）, glutathione peroxidase （ GSH-PX ）, malonyldialdehyde （MDA） and lipid oxide（LPO） were determined by biochemistry. Results Serum Lipids （TC, TG, LDL-C） and body mass index （BMI） were significantly higher in PH and EH compared to NT. MDA, LPO were significantly increased in groupPH and EH compared to NT[MDA, PH group（13.8 ± 2.2）, EH group（18.9± 2.0） vs NT group （ 10.5 ± 1.3 ）μmol/L, respectively, P〈0.05 and P〈0. 01 ; LPO, PH group （ 2.4± 0. 4）, EH group（ 2.8± 0.4 ） vs NT group （1.9±0. 2）μmol/L, respectively, P〈0. 05 and P〈0.01]. However, GSH-PX was increased in PH while decreased in EH [GSH-PX, PH group： （0. 22± 0.04） vs NT group： （0. 20±0. 03） μmol/L, P〈 0.05; EH group： （0.18± 0.04） vs NT group： （0. 20 ± 0. 03）μmol/L, P〈0.05]. SOD was significantly decreased in PH and EH in related to NT[SOD, PH group： （ 72.4 ± 10. 7）, EH group： （65.1 ± 10. 0） vs NT group： （79.0 ± 10. 2） U/mL, respectively, P〈0. 05 and P〈0.01]. Multivariate analysis showed BMI, SOD, GSH-PX, MDA, LPO were predisposing risk factors for prehypertension（p=0. 496, -0. 115, 1. 768, 1. 565, 1. 204; respectively, P〈0.05, P〈0. 05, P〈0. 05, P〈0. 01, P〈0. 01 ）. Conclusion Oxidative stress are enhanced in prehypertensive patients.