高血压不同时期β受体的变化及其意义

Changes of β-adrenoreceptors in peripheral lymphocytes at essential hypertension andtheir clinical significance.

目的探讨高血压病（ＥＨ）患者心肌β受体的变化与其病情的关系。方法采用３Ｈ－双氢阿普洛尔（３Ｈ－ｄｉｈｙｄｒｏａｌｐｒｅｎｏｌｏｌ）放射性配基结合分析法，测定６９例ＥＨ不同时期男性患者外周血淋巴细胞的β受体密度（与心肌β受体密度呈显著性正相关），并对各期１０例患者进行羟甲叔丁肾上腺素药物实验，以测定β受体敏感性。结果Ⅰ、Ⅱ期ＥＨ患者β受体的最大结合容量（βＭｍａｘ）分别较正常人增加３０．８％（Ｐ＜０．０１）和５６．７％（Ｐ＜０．００１），羟甲叔丁肾上腺素增加心率３０次／分的变时剂量（ＣＤ３０）分别较正常人降低２０．７％（Ｐ＜０．０１）和３７．９％（Ｐ＜０．００１），其中并发左室肥厚患者上述特征的显著性明显大于元左室肥厚患者（均Ｐ＜０．００１）。Ⅲ期ＥＨ患者βｍａｘ较正常人降低２７．２％，ＣＤ３０则较正常人增加２４．１％（均Ｐ＜０．０１），其中井发心力衰竭患者上述特征的显著性明显大于无衰竭患者（均Ｐ＜０．００１）。结论心肌β受体密度及功能的变化可能与ＥＨ及其并发左室肥厚与心力衰竭有关，提示，该参数可作为判断ＥＨ患者病情变化的一项指标。

Objective To explore the relation of β-adrenoreceptor density and function to patient'scondition in patients with essential hypertension (EH). Methods Sixty-nine male patients with EH at differentstages were included in study and 30 healthy subjects were used as control. β-adrenoreceptor maximum boundvolume (βmax) in periphery lymphocytes was measured by 3H-dihydroalprenolol (3H-DHA) radio ligand binding.β-adrenoreceptor responsiveness was determined by Salbutamol (injection). Results βmax was significantly higherin patients with EH at stages Ⅰand Ⅱ (P<0.01 and P<0.001, respectively) and the chronotropic dose of Salbutamol required to increase heart rate by 30 beats/min (CD30) was significantly lower (P<0.01 and P<0.001), respectively) than that in control group. was significantly lower and CD30 was significantly higher (allP<0.01) in patients with EH at stage Ⅲ than there in coned group. β was signifiantly higher and CD30 wassignificantly lower (all P<0.001) in patients with EH with left ventricular hypertrophy (LVH) than in thosewithout LVH. βmax was significantly lower and CD30 was significantly higher (all P<0.001) in patients with EHand heart failure than inthose without heart failure. Conclusion β-adrenoreceptor plays a role in the pathogensisof hypertension, hypertension complicated with ventricular hypertrophy and heart failure. β-adrenoreceptor densityand function may be viewed as an index for evaluating hypertensive Patient's condition.