白大衣高血压患者血清TNF-α、sIL-2R、IL-6水平的临床意义

The observation of level of tumor necrosis factor α,soluble interleukin 2 receptor and interleukin 6 in serum of white coat hypertension patients

目的 :观察白大衣高血压患者血清肿瘤坏死因子 - α(TNF- α)、可溶性白细胞介素 - 2受体 (s IL- 2 R)与白细胞介素 - 6 (IL- 6 )水平 ,评价其临床意义。方法 :采用酶标法 (EL ISA)测定原发性高血压组 (EH组 ,32例 )、白大衣高血压组 (30例 )及正常血压组 (30例 )血清 TNF-α(ng/ L )、s IL - 2 R(k IU / L )、IL - 6 (ng/ L )水平 ,并测量诊室血压及2 4h动态血压 (ABPM)值。结果 :1诊室血压参数 :EH组及白大衣高血压组收缩压 (SBP)、舒张压 (DBP)明显高于正常血压组 (P <0 .0 1 )。ABPM参数 ,EH组平均日间、平均夜间、平均 2 4h SBP及平均 2 4h DBP均明显高于白大衣高血压组及正常血压组 (P<0 .0 1 )。EH组平均日间、平均夜间 DBP高于白大衣高血压组及正常血压组(P <0 .0 5 )。2 EH组血清 TNF- α,s IL- 2 R,IL- 6水平均高于白大衣高血压组 (P <0 .0 5 )和正常血压组 (P <0 .0 1 )。白大衣高血压组 s IL- 2 R,TNF- α及 IL- 6水平明显高于正常血压组 (P <0 .0 5 ,<0 .0 1 )。结论 :白大衣高血压患者血清细胞因子水平介于 EH者与正常血压者之间 ,反映白大衣高血压时机体已产生免疫调节与自身保护 ,提示白大衣高血压是介于高血压与正常血压之间的临床状态 ,应视为

Objective:To investigate the level of tumor necrosis factor α (TNF α),soluble interleukin 2 receptor (sIL 2R),interleukin 6 (IL 6) in serum of hypertensives (n=32),white coat hypertensives (n=30) and normal blood pressure (BP) controls (n=30).Method:Clinic BP (mmHg) and 24 hour ambulatory blood pressure monitoring (ABPM,mmHg) were performed and the level of TNF α(ng/L),sIL 2R (kIU/L) and IL 6 (ng/L) in serum were determined by enzyme linked immunoscorbent assay (ELISA).Result:①Clinic BP of hypertension patients (SBP 155±12,DBP 98±5) and white coat hypertension patients (SBP 147±3,DBP 97±2) were markedly higher than normal BP controls (SBP 127±6,DBP 78±3) (P< 0.01 ).ABPM data of hypertension (day SBP 148±11,night SBP 134±8,24 h SBP 146±9,24 h DBP 95±4) were markedly higher than those of white coat hypertension (day SBP 126±4,night SBP 112±3,24 h SBP 124±5,24 h DBP 76±6) and those of normal BP controls (day SBP 124±4,night SBP 112±3,24 h SBP 122±3,24 h DBP 75±4) (P< 0.01 ).Day DBP (97±4) and night DBP (86±3) of hypertension patients were higher than those of white coat hypertension (day DBP 81±2,night DBP 71±4) and normal controls (day DBP 79±2,night DBP 68±6)(P< 0.05 ).②The level of TNF α ( 77.98 ± 59.76 ),sIL 2R ( 414.77 ± 185.49 ) and IL 6 ( 39.22 ± 31.93 ) in serum of hypertension patients and TNF α ( 69.50 ± 40.91 ),IL 6 ( 22.21 ± 45.65 ) of white coat hypertension were markedly higher than normal BP controls (TNF α 41.55 ± 36.52 ,sIL 2R 251.64 ± 116.26 ,IL 6 10.05 ± 13.22 ) (P< 0.01 ) .sIL 2R of white coat hypertension patients was higher than that of normal BP controls (P< 0.05 ).Conclusion:The level of cytoleukin in serum of white coat hypertension is between hypertension and normal BP controls.It means the regulation of immune function and self protection have taken place in white coat hypertension as hypertension patients and white coat hypertension is an early clinic stage of hypertension.