培哚普利对原发性高血压及左心室肥厚患者血浆corin水平的影响

Effect of perindopril on plasma corin level in essential hypertensive patients with left ventricular hypertrophy

目的探讨血浆corin与原发性高血压患者心房钠尿肽(ANP)、脑钠尿肽水平及左心室肥厚的相关性,以及培哚普利干预疗效。方法入选原发性高血压患者68例[左心室肥厚(LVH)组28例,无左心室肥厚(NLVH)组40例],均予以培哚普利治疗8周,以30名健康体检者作为对照组。用酶联免疫吸附试验(ELISA)法测定血浆corin、ANP和脑钠尿肽水平,超声心动图测量舒张期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD),并计算左心室质量指数(LVMI)。结果治疗前NLVH组、LVH组和对照组的血浆corin、ANP和脑钠尿肽浓度比较差异有统计学意义,且LVH组corin、ANP和脑钠尿肽明显高于NLVH组[(1950.3±401.9)比(1238.6±379.7)ng/L;(63.2±16.0)比(49.5±15.8)ng/L;(77.1±19.2)比(55.0±20.5)ng/L;均P<0.05]。Corin水平与LVMI、ANP和脑钠尿肽水平呈正相关(r=0.616,r=0.574,r=0.605,均P<0.01)。多元线性逐步回归分析显示,与LVMI独立相关的指标是corin和脑钠尿肽(β=0.504和0.171,均P<0.01);培哚普利治疗8周后,原发性高血压患者的corin、ANP及脑钠尿肽水平较治疗前降低[NLVH组:(1111.3±293.9)比(1238.6±379.7),(44.5±11.6)比(49.5±15.8),(47.2±14.2)比(55.0±20.5)ng/L,均P<0.05;LVH组:(1666.7±398.8)比(1950.3±401.9),(48.7±9.1)比(63.2±12.0),(48.3±10.5)比(77.1±19.2)ng/L,均P<0.01]。结论高血压患者血浆corin与ANP、脑钠尿肽水平呈正相关。血浆corin与高血压LVH呈正相关。培哚普利降压的同时可降低血浆corin水平。

Objective To explore the relationship among plasma corin,atrial natriuretic peptide（ ANP）,brain natriuretic peptide（ BNP） and left ventricular hypertrophy in patients with essential hypertension,and the treatment effects of perindopril. Methods A total of 68 patients with essential hypertension were divided into left ventricular hypertrophy（ LVH）group（ n = 28） and non-LVH（ NLVH） group（ n = 40）. All the patients were treated with perindopril for 8 weeks. And30 healthy volunteers served as the control group. Plasma concentrations of corin,ANP and BNP were determined by enzyme-linked immunosorbent assay（ ELISA）. The interventricular septal thickness（ IVST）,left ventricular posterior wall thickness（ LVPWT） at diastole and left ventricular end diastolic diameter（ LVEDD） were determined by echocardiography,and left ventricular mass index（ LVMI） was calculated. Results There were statistically significant differences in plasma concentrations of corin,ANP and BNP before treatment among the LVH,NLVH and control group,and which in the LVH group were significantly higher than those in the NLVH group [（ 1950. 3 ± 401. 9） vs（ 1238. 6 ± 379. 7） ng / L;（ 63. 2 ±16. 0） vs（ 49. 5 ± 15. 8） ng / L;（ 77. 1 ± 19. 2） vs（ 55. 0 ± 20. 5） ng / L; all P〈 0. 05]. Plasma corin level was positively correlated with the level of ANP,BNP and LVMI（ r = 0. 616,r = 0. 574,r = 0. 605,respectively,all P〈 0. 01）. Multiple linear stepwise regression analysis showed that corin and BNP were independently associated with LVMI（ β = 0. 504,0. 171; both P〈 0. 01）. After 8-week treatment,the levels of corin,ANP and BNP were decreased significantly in NLVH and LVH group [NLVH group：（ 1111. 3 ± 293. 9） vs（ 1238. 6 ± 379. 7）,（ 44. 5 ± 11. 6） vs（ 49. 5 ± 15. 8） and（ 47. 2 ± 14. 2） vs（ 55. 0 ± 20. 5） ng/L,all P 0. 05; LVH group：（ 1666. 7 ± 398. 8） vs（ 1950. 3 ± 401. 9）,（ 48. 7 ±9. 1） vs（ 63. 2 ± 12. 0） and（ 48. 3 ± 10. 5） vs（ 77. 1 ± 19. 2） ng/L,all P〈 0. 01]. Conclusion Plasma corin level is positively correlated with levels of ANP and BNP in essential hypertensive patients. Plasma corin is positively correlated with LVH. While perindopril decreasd the blood pressure,it could reduce plasma corin level.