胰岛素样生长因子1及25羟基维生素D与女性原发性高血压病的再研究

Restudy of Insulin-like Growth Factor 1 and 25 Hydroxyvitamin D and Female Primary Hypertension

目的:研究胰岛素样生长因子1(insulin-like growth factor,IGF-1)及25羟基维生素D在女性原发性高血压病患者中的表达,以及与T淋巴细胞亚群的关系对患者血压水平控制的关联性,为女性原发性高血压病临床预后评价提供敏感参考指标及理论依据。方法:选择2015年1月-2018年1月来该院就诊的女性原发性高血压患者180例为研究对象,采用全自动化学发光分析技术测定所有患者血清25(OH)D及胰岛素样生长因子1含量,依据检测结果将患者血清25(OH)D含量<30μg/L者117例作为研究A组,将25(OH)D含量≥30μg/L者63例作为研究B组;其间定期监测各组血压并计算血压变异系数用以显示血压控制情况,3年内持续跟进患者;采用自动免疫芯片技术测定患者外周静脉血T淋巴细胞亚群CD4、CD8含量并计算其比值;同时与该院体检的健康老年女性80例(对照组)的前述相应指标进行对照比较。结果:研究A组、研究B组、对照组的25(OH)D含量分别为(20.1±8.9)、(50.1±11.5)、(94.3±23.4)μg/L,两两比较差异均有统计学意义(P<0.05)。研究A组、研究B组、对照组的胰岛素样生长因子1分别为(275.0±38.5)、(280.0±40.1)、(145.0±30.4)ng/m L,研究A组与研究B组比较,差异无统计学意义(P>0.05),研究A组与对照组比较,差异有统计学意义(P<0.05)。研究A组、研究B组、对照组的收缩压变异系数分别为14.7%、15.1%、5.8%;舒张压变异系数分别为7.4%、7.2%、7.0%,研究A组与B组的收缩压变异系数与对照组比较,差异均有统计学意义(P<0.05),舒张压变异系数与对照组比较,差异均无统计学意义(P>0.05)。研究A组和B组的CD4、CD8均较对照组异常表达,CD4/CD8比值均较对照组降低,差异均有统计学意义(P<0.05)。结论:女性原发性高血压病患者25(OH)D呈低表达,胰岛素样生长因子1较健康女性显著增高,T淋巴细胞亚群之CD4、CD8及其比值在女性原发性高血压患者中异常表达。

Objective：To investigate the relationship between the expression of insulin-like growth factor 1 and 25 hydroxyvitamin D in women with essential hypertension and the relationship with T-lymphocyte subsets on the control of blood pressure in patients with essential hypertension clinical prognostic evaluation provides a sensitive reference index and theoretical basis.Method：A total of 180 female essential hypertension patients from January 2015 to January 2018 in our hospital were selected for the study.The levels of serum 25（OH）D and insulinlike growth factor 1 according to the test results,117 patients with serum 25（OH）D less than 30 μg/L as study group A and 63 patients with 25（OH）D greater than or equal to 30 μg/L as study group B;during which regular monitoring of blood pressure and blood pressure coefficient of variation was calculated to show blood pressure control,sustained follow-up of 3 years;using automated immunochips technology in patients with peripheral venous blood T lymphocyte subsets CD4 and CD8 content and calculate its ratio;at the same time with the hospital physical examination of 80 healthy elderly women（control group） the corresponding indicators for comparison.Result：The contents of 25（OH）D in study group A,study group B and control group were（20.1±8.9）,（50.1±11.5）,（94.3±23.4）μg/L,there were no significant differences between the two groups（P〈0.05）.The insulin-like growth factor 1 in study group A,study group B,control group were（275.0±38.5）,（280.0±40.1）,（145.0±30.4）ng/m L,respectively,there was no significant difference between study group A and study group B（P〈0.05）,the difference between study group A and control group was statistically significant（P〈0.05）.The coefficient of variation of systolic blood pressure（SBP） in study group A,study group B and control group were 14.7%,15.1% and 5.8%,respectively,and the coefficient of variation of diastolic blood pressure was 7.4%,7.2% and 7.0%,respectively,the coefficient of variation of systolic blood pressure in study group A and study group B was significantly different from that in control group（P〈0.05）.The coefficient of variation of diastolic blood pressure were not significantly different from that of control group（P〈0.05）.The ratio of CD4/CD8 in study group A and study group B were significantly lower than that in control group（P〈0.05）,and the ratio of CD4/CD8 in study group A and study group B were significantly lower than that in control group（P〈0.05）.Conclusion：The expression of 25（OH）D in female patients with essential hypertension is low,and the expression of insulinlike growth factor 1 was significantly higher than that of healthy women,the CD4/CD8 and its ratio of T lymphocyte subsets in female patients with essential hypertension were significantly higher than those in healthy women.