血浆PRA,AT-Ⅱ,NPYRIA在原发性高血压分型和治疗中的应用

Application of RIA of PRA, ATⅡ and NPY in Typing and Therapy of EH Patients

目的 :为了进行原发性高血压分型和AT -Ⅱ受体抑制剂的实验研究。方法 :2 0 8例原发性高血压 (EH)患者和 10 0例正常对照组作了血浆PRA、AT -Ⅱ和NPY放射免疫分析 ,40例EH进行了AT -Ⅱ受体抑制剂治疗前后血浆中NPY的测定。显著性检验为t检验 ,批内CV <10 % ,批间CV <15 %。结果 :2 0 8例EH以PRA增高、正常和降低分型分别为 17 8% ,71 6 %和 10 6 % ,12 8例EH以AT -Ⅱ分型分别为 2 0 3% ,6 4 1%和15 6 % ,两者符合率为 82 % ,6 9例EH血浆中NPY明显高于 40例正常对照组 ,17例Ⅰ级、2 8例Ⅱ级和 2 4例Ⅲ级EH血浆中NPY分别为 137 3± 32 6pg/ml,148 5± 41 1pg/ml和 16 2 4± 42 7pg/ml,40例EH进行了AT -Ⅱ受体抑制剂治疗 ,血浆中NPY随血压降低 ,NPY亦降低。结论 :EH以PRA和AT -Ⅱ分型有助于AT受体抑制剂的治疗 ,NPY是疗效观察的有效指标之一。

Objective To study the typing and ATⅡ receptor inhibitor therapy for essential hypertension (EH) patients. Methods Plasma RA, ATⅡ and NPY levels were measured by radioimmunoassay (RIA) in 208 Patients with EH and 100 controls; plasma NPY levels were measured in 40 EH patients before and after ATⅡ receptor inhibitor therapy. The mean coefficient of variation for intra and inter batch-assay were less than 10% and 15% respectively. Results In 208 EH patients plasma PRA levels were increased, normal and decreased in 17.8%、 71.6% and 10.6% respectively, while in 128 EH patients Plasma ATⅡ levels were inereased, normal and decreased in 20.3%、 64.1% and 15.6% respectively. In 69 EH Plasma NPY levels were significantly higher than those in 40 control subjects. (17 grade Ⅰ EH, 137.3±32.6pg/mL; 28 grade Ⅱ EH, 148.5±41.1pg/mL; 24 grade Ⅲ EH, 162.4±42.7pg/mL; 40 controls, 118.5±30.5pg/mL). In 40 EH patients plasma NPY levels were decreased after ATⅡ receptor inhibitor therapy as the blood pressure decreased. Conclusion Typing of EH patients according to levels of plasma PRA and ATⅡ is useful in guiding treatment. ATⅡ receptor inhibitors are indicated in those patients with increased plasma levels and NPY levels can be used for apprasial of the freatment efficacy.