原发性高血压患者血清胱抑素C与左室构型的关系

Correlation between the serum systatin C level and left ventricular geometry in primary hypertension patients

目的 研究心功能正常范围原发性高血压患者血清胱抑素C（CysC）水平与左室构型变化的关系,探讨左室重构与CysC的相关性,并探讨其机制.方法 纳入收缩功能正常（LVEF＞50％）原发性高血压患者180例为试验组,正常体检者50名为对照组.检测血清CysC浓度并行超声心动图检查,测量左室舒张末期内径（LVDD）、室间隔厚度（ⅣS）、左室后壁厚度（LVPW）,并计算左室重量指数（LVMI）、室壁相对厚度（RWT）.按Ganau’s分类法,将试验组分为正常型、向心性重构型、向心性肥厚型、离心性肥厚型4种构型,对各组间血浆CysC水平进行两两比较.结果 试验组较对照组血清CyaC浓度明显升高（P＜0.05）.按Ganau’s分类后,以向心性肥厚组CysC水平升高最显著（P＜0.05）,向心性构型组和离心性肥厚组依次次之（P＜0.05,P＜0.05）,正常构型组CysC水平升高最低.正常构型组较对照组CysC水平升高,但差异无统计学意义（P＞0.05）.结论 原发性高血压患者血清CysC浓度与左室构型相关,CysC在原发性高血压左室构型的变化发展中起着一定作用.

Objective To study the correlation between the serum systatin C level and left ventricular ge- ometry in primary hypertension. Methods One hundred and eighty patients diagnosed as primary hypertension with normal heart function and 50 normal controls were enrolled in this study. The concentration of serum CysC were tested in all patients. Then LVDD, IVS, LVPW were measured using echocardiography and LVMI, RWT was evaluated. According to Canaus＇s category, the patients with primary hypertension were divided into four groups： normal geometric pattern group, concentric remodeling hypertrophy group and concentric hypertrophy group. Results The serum systatin C level in patients with hypertension was higher than that in control group（P〈 0.05 ）. The serum systatinC level was highest in patients with concentric hypertrophy（P〈0.05 ）, followed by that of the patients with eccentric hypertrophy and then concentric remodeling. Though higher than that of the controls, no significant difference of CysC concentration was found in the normal geometric patter group. Conclusion The serum level of CysC is related with left ventricular geometry. The concentration of serum CysC may play a role in the development of left ventricular geometry.