杓型和非杓型高血压的T淋巴细胞亚群的差异与分析

Differences of T lymphocyte subsets in dippers and non-dippers hypertension

目的考察和分析杓型和非杓型高血压的T淋巴细胞亚群的差异。方法收集2015年1月至2016年4月在本院收治的高血压患者204例,将患者分为2组:101例杓型组和103例非杓型组。并选择85例同期健康体检者,96例脑梗死恢复期的患者为对照组。结果治疗后,两组高血压的24h平均收缩压、日间平均收缩压和夜间平均收缩压明显降低(P<0.05),杓型组的舒张压、日间平均舒张压和夜间平均舒张压无明显降低(P>0.05),非杓型组的24h平均舒张压、日间平均舒张压和夜间平均舒张压均降低(P<0.05),与杓型组比,非杓型组的血压仍处于较高水平(P<0.05)。与正常组和脑梗死恢复期组比,两组高血压患者的T淋巴细胞亚群的CD3^+、CD4^+和CD4^+/CD8^+明显升高(P<0.05),CD8^+明显降低(P<0.05),治疗后,两组高血压的CD3^+、CD4^+和CD4^+/CD8^+均明显降低,CD8^+明显增高。治疗前后,与杓型组比,非杓型组的CD3^+、CD4^+和CD4^+/CD8^+明显升高(P<0.05),CD8^+明显降低(P<0.05)。结论 (1)T淋巴细胞亚群变化参与了高血压的发生发展过程,对24h血压节律异常产生重要作用;(2)非杓型是高血压的危险因素,T淋巴细胞亚群异常参与其中,但机制尚未完全明确,仍有待深层次地研究。

Objective To inves tigate the dif ferences of Tlymphocyte subsets in dippers and non -dippers hypertension. Method From January 2015 to April 2016 , two hund red and four case shypertension patients in our hospital were divided into 2 groups： one hundred and one cases in the dipper group and a hundred and three cases in the non-dipper group. Eighty-five cases health volunteers and ninety-six cases cerebral infarction in recovery period patients were collected as the control groups. Results After tre a tm en t , 2 4 -h o u r average systolic blood p re s s u re ,1 2 - hour daily average systolic blood pressure and 12-hours night average systolic blood pressure had decreased in 2 hypertension groups（ P〈0.05）. 24-hour average diastolic blood pressure, 12-hour daily average diastolic blood pressure and 12-hour night average diastolic blood pressure did not change in dipper group（ P〉0.05）. 24-hour average diastolic blood pressure, 12-hour daily average diastolic blood pressure and 12-hour night average diastolic blood pressure had decreased in non-dipper group（ P〈0.05）. Compared with dipper group, blood pressure had increased in non-dipper group （ P〈0.05）. Compared with the health volunteers and cerebral infarction in recovery period groups, T lymphocyte subsets CD3＋, CD4＋ and CD4＋/CD8＋ had increased（ P〈0.05）, CD8＋ had decreased in 2 hypertensive group（ P〈0.05）. After treatment, CD3＋, CD4＋ and CD4＋/CD8＋ had decreased（ P〈0.05）, CD8＋ had increased in 2 hypertensive groups （ P〈0.05） . Compared with dipper group, CD3＋, CD4＋ and CD4＋/CD8＋ had increased（ P〈0.05）, CD8＋ had decreased significantly in non-dipper group（ P〈0.05）. Conclusion T lymphocyte subsets participate in the occurrence and development of hypertension and play an important role in the abnormal blood pressure rhythm of 24h. Non-dipper hypertension is a risk factor for hypertension. T lymphocyte subsets have involved in the development and progression of hypertension, but the mechanism is not yet completely cleared, which needs deeper study.