原发性高血压患者血清Ⅰ型胶原代谢变化及意义

Characteristic of collagen type I metabolism in essential hypertension

目的 :测定原发性高血压 (EH)患者 型原胶原羧基端前肽 (PIP)和 型胶原羧基端端肽 (CIPT)的血清浓度以及尿系列蛋白和超声心动图舒张功能参数的变化及临床意义。方法 :采用放射免疫分析法测定 138例EH患者 (EH组 )和 34例正常人 (对照组 )的血清 PIP和 CIPT的血清浓度。应用酶标法测尿系列蛋白和超声心动图测定左室结构、舒张功能参数。结果 :EH组血清 PIP水平较对照组显著增加 [(10 8.0 4± 2 9.70 )μg/ L∶ (94.5 0± 19.5 5 )μg/ L ,P <0 .0 2 ];CIPT两组之间无显著差别 [(3.37± 0 .6 7)μg/ L∶ (3.19± 0 .71)μg/ L ,P >0 .0 5 ]。EH组尿微量白蛋白 ,转铁蛋白和 Ig G均显著高于对照组。超声心动图的舒张功能参数与对照组比较也有显著差别。结论 :EH患者可能有心肌间质和肾小球 I型胶原合成增加 ,而降解不变 ,合成和降解不平衡是造成这些器官反应性纤维化的原因之一。

Objective:To investigate the characteristic of collagen type I metabolism in patients with essential hypertension (EH).Method:The serum concentration of carboxy terminal peptide of procollagen type I(PIP) and carboxy terminal telopeptide of collagen type I (CIPT) were measured by specific radio immunoassay in EH patients (n=138) and in normotensive control subjects (n=34).A series of urinary microproteins were measured by enzymic signal method.Several parameters of left ventricular anatomy and function were recorded using echocardiography.Result:Serum concentration of PIP was markedly higher in EH patients than in normal subjects [( 108.04 ± 29.70 )μg/L vs ( 94.50 ± 19.55 )μg/L,P< 0.02 ].Serum concentration of CIPT was not different between EH patients and normal subjects [( 3.37 ± 0.67 )μg/L vs ( 3.19 ± 0.71 )μg/L,P> 0.05 ].A series of urinary microproteins (mAlb,TRF,IgG) were significant higher in EH patients than in normal subjects. Several parameters of left ventricular anatomy and function (LA,LVMI,IVRT,A/E and PA) were markedly higher in EH patients than in normal subjects.Conclusion:These findings suggest that the synthesis of myocardial interstitium and glomerulus collagen type I is increased but degradation of collagen type I is normal in patients with EH.We think that organ reactive fibrosis in EH results from the abnormal equilibrium between synthesis and degradation metabolism.