高血压病患者血清Ⅲ型前胶原含量变化及临床意义

SERUM TYPE Ⅲ PROCOLLAGEN IN ESSENTIAL HYPERTENSION AND ITS CLINICAL SIGNIFICANCE

目的 :从临床角度探讨高血压病患者血清Ⅲ型前胶原 (PcⅢ )含量变化及其检测的临床意义。方法 :运用放射免疫法测定高血压病患者及健康人血清PcⅢ含量及血浆血管紧张素Ⅱ (AngⅡ )、醛固酮 (Ald)、血浆肾素活性 (PRA)水平 ,超声测定所有观察对象的左心室收缩和舒张功能。高血压患者苯那普利治疗 4个月后复查各指标。结果 :高血压病患者血清PcⅢ含量明显升高 (P <0 .0 1) ,且与血浆AngⅡ、Ald呈正相关 (P <0 .0 1)与左心室舒张功能指标 :二尖瓣口舒张早期及晚期最大血流速度比 (VE/VA)呈负相关 (P <0 .0 1) ,与收缩功能指标无关。苯那普利治疗 4个月后血清PcⅢ明显下降 ,VE/VA 升高。结论 :血清PcⅢ含量水平与血压升高密切相关 ,并可反映高血压病左心室舒张功能及心肌间质纤维化程度 。

Objective:The aim of this study was to discover the variation of serum type Ⅲ Procollagen (PcⅢ) in essential hypertension and to assess the value of its measurement.Methods:The serum concentrations of PcⅢ were measured by radioimmunoassy as well as plasma of AngⅡ,Ald and PRA.Ultra-sonic recording was obtained from all patients to determined the functions of the left ventricular diastolic blood pressure and systolic blood pressure.Patients were treated with benazeprie for four months then measurements was taken again.Results:Increased serum concentrations of PcⅢ were found in hypertensive patients as compared with normotensive subjects (P<0.01).The serum PcⅢ correlated directedly with the plasma concentration of Ang Ⅱ and Ald.An inverse correlation was found between serum PcⅢ and the ratio between maximal early transmittal flow velocity and maximal late transmittal flow velocity (V E/V A)(P<0.01).No significant serum PcⅢ difference was noted with different left ventricular hypertrophy.Considerately decreased values were found in PcⅢ while V E/V A ratio increased after 6 months treatment.Conclusions:Serum concentrations of PcⅢ are tightly correlated with the raise of blood pressure,it can help to evaluate the diastolic function of left ventricular,reflect the degree of myocardial interstitial fibrosis and indirectly indicate the effect of anti-fibrosis therapy in myocardial interstitial fibrosis.