高血压病患者不同左心室几何构型血浆心肌营养素-1水平的变化

Relationship between plasma cardiotrophin 1 and left ventricular geometry in patients with essential hypertension

目的探讨高血压病患者不同左心室几何构型与血浆心肌营养素-1(CT-1)水平的关系。方法对80例血压达标的高血压病患者进行超声心动图检查,依据左心室质量指数(LVMI)、左心室相对室壁厚度将患者分为左心室正常构型组(n=20)、向心性重构组(n=22)、向心性肥厚组(n=20)和离心性肥厚组(n=18)。健康体检者为对照。ELISA法测定血浆CT-1水平。结果所有高血压病患者血浆CT-1水平显著高于对照组(P<0.01)。血浆CT-1水平:左心室向心性重构组显著高于正常构型组(P=0.004)、向心性肥厚组显著高于向心性重构组(P=0.049)、离心性肥厚组显著高于向心性肥厚组(P=0.001)。左心室向心性肥厚组(r=0.626,P=0.009)、离心性肥厚组(r=0.573,P=0.017)患者的血浆CT-1水平与LVMI显著正相关。结论对于血压控制达标的高血压病患者,血浆CT-1水平仍可以很好地反映左心室质量的严重程度。

Objective To investigate the relationship between the levels of plasma eardiotrophin I（CT-1） and left ventricular geometry in patients with essential hypertension. Methods 80 essential hypertension patients who achieved successful blood pressure control were studied with eehocardiographie examination. According to left ventricular mass index （LVMI） and relative wall thickness （RWT）, the patients were divided into left ventricular normal geometry group （n=20）, concentric remodeling group （nffi22）, concentric hypertrophy group （nffi20） and eccentric hypertrophy group （n=18）： 20 healthy subjects were enrolled as control. The levels of plasma CT-1 were measured by enzyme linked immunosorbent assay （ELISA）. Results The levels of plasma CT-1 were higher in all the patients with essential hypertension than in the healthy controls （P〈0.01）. Compared with the normal geometry group, plasma CT-1 levels were higher in the concentric remodeling group[（94.50±25.67）pg/ml vs. （69.60±14.94） pg/ml, P=0.004]. The levels of plasma CT-1 were higher in the concentric hypertrophy group[（117.45±24.34） pg/ml] than in the concentric remodeling group （P=-0.049）, but lower than in the eccentric hypertrophy group[（171.78±42.77）pg/ml, P=0.001]. There was a significant positive correlation between the levels of plasma CT-1 and LVMI （P〈0.05） in patients with left ventrieular hypertrophy（LVH）. Conclusion Plasma CT-1 has discriminative value in identifying the presence of LVH even in essential hypertension patients achieving successful blood pressure control.