高血压心肌纤维化中S100A4的作用及天麻钩藤饮的调控

The intervention of Tianma Gouteng Decoction to hypertension myocardial fibrosis and its effect on S100A4

目的:研究探讨原发性高血压心肌纤维化患者血清S100A4的意义,及天麻钩藤饮的调控作用。方法:纳入2013年8月至2015年2月本中心门诊确诊为原发性高血压患者112例,按照左心室质量指数(left ventricular mass index,LVMI)值将其分为非左室肥厚(non left ventricular hypertrophy,NLVH)组40例和左室肥厚(left ventricular hype Ircrophy,LVH)组72例;将LVH组患者72例随机分为开博通组35例,天麻钩藤饮37例。均给药4周,观察治疗前后各组患者血压和LVMI变化,及各组患者外周血清S100A4蛋白、血清透明质酸酶(HA)及和层粘连蛋白(LN)变化情况。结果:经治疗后3组患者收缩压、舒张压和LVMI较治疗前明显下降(P<0.01)。治疗前LVH组患者血清S100A4、HA、LN表达水平较NLVH组显著升高(P<0.05)。治疗4周后,LVH组中两组患者血清S100A4、HA、LN表达水平均较治疗前显著降低(P<0.05),与开博通组比较,天麻钩藤饮组血清S100A4、HA、LN表达显著降低(P<0.05);且血清S100A4表达与血清中HA、LN表达呈显著正相关。结论:S100A4可作为评估高血压心肌纤维化的有效指标,中药方剂天麻钩藤饮可通过降低S100A4水平进而阻止高血压心肌纤维化的发生发展。

Objective： To study the effect of Tianma Gouteng Decoction hypertension myocardial fibrosis and its effect on the expression of S100A4. Methods： 112 patients with hypertension admitted between Aug 2013 and Feb 2015 were divided into the non left ventricular hypertrophy（ NLVH） group（ n = 40） and the left ventricular hypertrophy（ LVH） group（ n = 72） according the value of the left ventricular mass index（ LVMI）. And 72 patients in LVH group were randomly divided into captopril group（ n = 35） and Tianma Gouteng Decoction group（ n = 37）. The markers of S100A4,hyaluronic acid（ HA） and Laminin in serum were measured before and after treatment,the change of blood pressure and LVMI were observed before and after treatment. Results： The blood pressure was controlled into normal level compared with prior treatment（ P 〈 0. 05）,but there was no distinct difference between captopril group and Tianma Gouteng Decoction group（ P 〉 0. 05）. Before the treatment,the expression of S100A4,hyaluronic acid（ HA） and Laminin were in LVH group were higher than the NLVH group.And after treatment,serum S100A4,hyaluronic acid（ HA） and laminin were significantly decreased in both captopril group and Tianma Gouteng Decoction group,but Tianma Gouteng Decoction group decreased more.Conclusion： The levels of S100A4 may be easy and valuable method in estimating essential hypertension myocardial fibrosis,and Tianma Gouteng Decoction can suppress the development of the hypertension myocardial fibrosis by down-regulating the level of S100A4 in serum.