老年高血压患者非酶糖基化与血管硬化及左室舒张功能的相关性

Association of non-enzymatic glycosylation with angiosclerosis and left ventricular diastolic function in the elderly with hypertension

目的探讨老年高血压患者羧甲基赖氨酸(CML)和可溶性糖基化终产物受体(sRAGE)水平与血管硬化及左室舒张功能的关系。方法 84例老年高血压住院患者,采用ELISA法检测CML和sRAGE水平;用全自动动脉硬化测量仪测定动脉搏波传导速度(PWV);多普勒超声心动仪测量左心室舒张早期血流速度(E)、舒张晚期血流速度(A)及E/A,左心室舒张早期运动速度(Em)、晚期运动速度(Am)及Em/Am。结果单因素分析显示,PWV与年龄、CML、sRAGE呈正相关(P<0.05);E/A、Em/Am和年龄、CML、sRAGE均呈负相关(P<0.05)。多元回归分析显示,sRAGE与PWV、E/A、Em/Am无明显相关(P>0.05)。sRAGE与CML呈显著正相关(P<0.01)。结论老年高血压人群晚期糖基化终产物(AGEs)水平的升高影响血管硬化过程的同时也导致左室舒张功能下降;临床上可将降低AGEs水平作为减缓血管硬化的一种干预手段。

Objective To study the association of serum carboxymethyl（lysine）-adducts and soluble receptor for advanced glycation end-products（sRAGE） with angiosclerosis and left ventricular diastolic function in the elderly with essential hypertension（EH）. Methods Serum CML and sRAGE were measured by ELISA in 84 EH elder patients.Auto-survey atherosclerosis apparatus was applied to examine pulse wave velocity（PWV）. The maximal velocity of mitral flow E peak and A,the early diastolic velocity（Em） and the late diastolic velocity（Am） were measured by two-dimensional echocardiography.The E/A and Em/Am were measured. Results The univariate analysis showed that PWV was positively correlated to age,CML and sRAGE（P0.05）.E/A and Em/Am were negatively correlated to age, CML and sRAGE（P0.05）. The multiple regression analysis showed that there was no significant correlation between sRAGE and PWV,E/A,Em/Am（P0.05）.sRAGE was positively correlated to CML（P0.01）. Conclusion Elevated serum advanced glycation end-products（AGEs） are associated with increased arterial stiffness and decreased diastolic function in the elderly with EH.An intervention of decreasing AGEs may be taken as a novel strategy to lower arterial stiffness.