血清胰岛素样生长因子-1和一氧化氮水平与原发性高血压关系的临床研究

Clinical Research on Correlation Between Essential Hypertension and the Levels of Serum Insulin Growth Factor-1 and Nitric Oxide

目的探讨血清胰岛素样生长因子-1（IGF-1）及一氧化氮（NO）水平与原发性高血压（EH）及左心室肥厚（LVH）的关系。方法入选EH患者100例,为初次尚未服药治疗或服药后但血压控制不满意者,分为1、2、3级,计算左心室重量指数（LVMI）,LVMI〉125 g/m2（男）或〉120 g/m2（女）,为LVH。分为LVH（46例）组和无LVH（54例）组。另40例健康体检者作为对照组。分别用放射免疫法测定血清IGF-1及硝酸还原酶法测定血清NO水平。100例EH患者降压治疗3月后再次测定血压与血清IGF-1水平。结果 EH患者血清IGF-1水平（358.6±52.6）ng/ml高于正常对照组（142.5±41.3）ng/ml,血清NO水平（41.5±23.7）μmol/L低于对照组（82.1±20.8）μmol/L。EH组血压1-3级间血清IGF-1的水平（分别为257.6±45.3、329.4±32.8、412.3±41.5 ng/ml）随着EH级数的增加而增加且不同级数之间差异有统计学意义,NO的水平（分别为63.4±15.2、48.5±19.8、32.5±21.6μmol/L）随着EH级数的增加而降低且不同级数之间差异有统计学意义。EH伴LVH者血清IGF-1水平（387.4±35.8）ng/ml高于无LVH者（296.6±40.2）ng/ml,血清NO水平（34.3±18.2）μmol/L低于无LVH者（57.9±22.2）μmol/L。EH组经药物治疗3月后血压达标者的血清IGF-1水平（259.2±42.6）ng/ml低于血压未达标者（324.6±37.2）ng/ml,血清NO水平（75.6±12.9）μmol/L高于血压未达标者（46.2±15.3）μmol/L。结论 EH患者IGF-1升高,NO降低,可能参与高血压LVH的调节。其水平可以较好地反映LVH的程度。

Objective To explore the relationship between the serum levels of IGF- 1 and nitric oxide with essential hypertension and left ventricular hypertrophy. Methods One hundred EH patients without initial treatment or with unsatisfactory blood pressure （EH grades Ⅰ,Ⅱ and Ⅲ after the therapy were recruited and divided into LVH group （n= 46） and non- LVH group （n= 54）. 40 physical examinees were served as control group. The serum level of IGF 1 was detected by radioim- munoassay and the serum level of NO was determined using nitrate reductase rhethod. After three months of treatment, the serum levels of IGF- 1 and NO of 100 EH patients were measured. Results The serum level of IGF 1 （358.6 ± 52.6 ng/ ml） in patients with EH was significantly higher than that （142.5 ± 41.3 ng/ml） in normal controls, but the serum level of NO （41.53 ± 23.7 μmol/L） was lower than that （82.1 ± 20.8μmol/L） of normal controls. There were statistically significant differences in the serum levels of IGF- 1 （257.6 ± 45.3 ng/ml, 329.4 ± 32.8 ng/ml, 412.3 ± 41.5 ng/ml） and NO （63.4 ± 15.2 μmol/L, 48.5 ± 19.8μmol/L, 32.5 ± 21.6μmol/L） among the EH grades I, II and Ill. The serum level of IGF 1 was higher in EH with LVH （387.4 ± 35.8 ng/ml） than EH without LVH （296.6 ± 40.2 ng/ml）, while the serum level of NO was lower in EH with LVH （34.3 ± 18.2μmol/L） than EH without LVH （57.9 ± 22.2μmol/L）. After 3 months of treatment, the serum level of IGF - 1 decreased more significantly in patients with normal blood pressure （259.2 ± 42.6 ng/ml） than in patients with abnormal blood pressure （324.6 ± 37.2 ng/ml）, while the serum level of NO increased more significantly in patients with normal blood pressure （75.6 ± 12.9μmol/L） than in patients with abnormal blood pressure （46.2 ± 15.3μmol/L）. Conclusions The increased level of serum IGF- 1 and decreased level of serum NO may be interacted arid involved in the regulation of LVH in patients with EH. IGF- 1 and NO may play the important roles in the occurrence and development of LVH.