TWEAK与原发性高血压患者心脏重塑的相关性

Correlation between TWEAK and cardiac remodeling in essential hypertensive patients

目的探究肿瘤坏死因子样凋亡微弱诱导剂(TWEAK)与原发性高血压患者心脏重塑的关系。方法选取原发性高血压5年以上患者88例为高血压组,检测血清TWEAK水平并分为高表达组(n=51)和低表达组(n=37);选取同期健康体检者20例为对照组。采用RT-PCR法检测入选者外周血单个核细胞(PBMCs)中TWEAK mRNA表达量,采用ELISA法检测血清中可溶性TWEAK(s TWEAK)和基质金属蛋白酶1(s MMP-1)表达水平;超声心动图测量左心房直径(LAD)、左心房容积(LAV)、左心房容积指数(LAVI)、二尖瓣血流频谱舒张早期波E峰(E)、二尖瓣血流频谱心房收缩波A峰(A)、二尖瓣环舒张早期与心房收缩期峰值运动速度比(E/A),二尖瓣环侧壁运动频谱峰值比值(E/E')。结果高表达组和低表达组s TWEAK、TWEAK mRNA、s MMP-1水平均高于对照组(P<0.05),且高表达组显著高于低表达组(P<0.01);高表达组和低表达组LAVI、E/E'均高于对照组(P<0.05),且高表达组显著高于低表达组(P<0.01);s TWEAK、TWEAK mRNA与s MMP-1、LAVI、E/E'呈显著正相关性(P<0.01)。结论高血压患者心脏重塑可能与TWEAK高表达有关。

Objective To investigate the association between tumor necrosis factor-like weak inducer of apoptosis （TWEAK） and cardiac remodeling in essential hypertensive patients. Methods A total of 88 hypertensive patients en- rolled as the hypertension group were divided into two subgroups according to the serum level of soluble TWEAK （sTWEAK） ： high sTWEAK group （ n = 51 ） and low sTWEAK group （ n = 37 ）. Another 20 healthy subjects served as the control group. The mRNA expression of TWEAK in peripheral blood mononuclear cells （PBMCs） was detected u- sing real-time PCR （RT-PCR）. sTWEAK and matrix metalloproteinase 1 （sMMP-1） were measured with enzyme linked immunosorbent assay （ELISA）. The left atrium diameter （LAD）, left atria/volume （LAV）, left atrial volume index （LAVI）, early wave of mitral flow （E）, atrial wave of mitral flow （A）, ratio of mitral flow early wave to atrial wave （E/A）, and ratio of mitral flow early wave to mitral annular early diastolic velocity （E/E＇） of mitral valve ring were measured with echocardiography. Results The levels of sTWEAK, TWEAK mRNA and sMMP-1 were higher in the hypertension group than in the control group （ P 〈 0.05 ）, These indexes were significantly greater in the high sTWEAK group than in the low sTWEAK group （ P 〈 0.01 ）. LAVI and E/E＇ were greater in the hypertension group than in the control group （ P 〈 0.05 ）, and were significantly greater in the high sTWEAK group than in the low sTWEAK group （ P 〈 0.01 ）. Furthermore, the sTWEAK and TWEAK mRNA showed a significant positive correlation with sMMP-1, LAVI and E/E＇ （ P 〈 0.01 ）. Conclusion Cardiac remodeling in essential hypertensive patients might be correlated with up-regulated TWEAK.