高血压患者外周血IGF-1、TGF-β1水平与心血管重构和肾损伤的关系

Relationship between peripheral blood IGF-1, TGF-beta 1 levels and cardiovascular remodeling and renal injury in patients with hypertension

目的研究高血压患者外周血胰岛样生长因子-1(IGF-1)、转化生长因子β1(TGF-β1)水平与心血管重构和肾损伤的关系。方法选择2014年7月~2017年7月于淄博市张店区中医院治疗的高血压患者109例作为研究对象。另选同期在医院接受健康体检的志愿者100例作为对照组,检测并对比两组患者颈动脉的内膜中层厚度(IMT)、左心室质量指数(LVMI)、尿白蛋白排泄率(UAER)、IGF-1及TGF-β1,观察组根据IMT、LVMI、UAER水平再分为各个亚组,探讨IGF-1、TGF-β1与IMT、LVMI及UAER的相关性。结果观察组的IMT、LVMI、UAER、IGF-1和TGF-β1水平均分别明显高于对照组,差异均有统计学意义(P均<0.05)。根据IMT将观察组分成3个亚组,其中粥样斑块组和增厚组患者的IGF-1和TGF-β1水平均明显高于正常组,且粥样斑块组又明显高于增厚组,差异均有统计学意义(P均<0.05)。根据LVMI将观察组分成2个亚组,其中左心室肥厚组患者的IGF-1和TGF-β1水平均分别明显高于无左心室肥厚组,差异均有统计学意义(P均<0.05)。根据UAER将观察组分成3个亚组,其中临床白蛋白尿组和微量白蛋白尿组的IGF-1和TGF-β1水平均明显高于正常组,且临床白蛋白尿组又明显高于微量白蛋白尿组,差异均有统计学意义(P均<0.05)。Spearman分析显示,患者IGF-1和TGF-β1均分别与IMT、LVMI及UAER水平呈正相关(P均<0.05)。结论高血压患者的外周血IGF-1和TGF-β1水平与其心血管重构及肾损伤均具有紧密联系,临床上可通过对IGF-1和TGF-β1水平实施监测,从而更好地防止高血压患者心、肾等器官功能的损害。

Objective To investigate the relationship between peripheral blood islet like growth factor-1(IGF-1),transforming growth factor beta 1(TGF-β1)levels and cardiovascular remodeling and renal injury in patients with hypertension.Methods From July 2014 to July 2017,109 patients with hypertension were selected as the research objects.In the same period,100 volunteers who received a physical examination at the hospital were selected as a control group.Carotid intima-media thickness(IMT),left ventricular mass index(LVMI),urinary albumin excretion rate(UAER),IGF-1 and TGF-β1 were detected and compared between the two groups.The observation group was further divided into subgroups according to the levels of IMT,LVMI,and UAER,and the correlation between IGF-1,TGF-β1 and IMT,LVMI,and UAER was investigated.Results The IMT and LVMI,UAER,IGF-1 and TGF-β1 of the observation group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The observation group was divided into three subgroups according to IMT,the levels of IGF-1 and TGF-β1 in atherosclerotic plaque group and thickening group were significantly higher than those in normal group,and the atherosclerotic plaque group was significantly higher than the thickening group,the differences were statistically significant(P<0.05).The observation group was divided into two subgroups according to LVMI.The levels of IGF-1 and TGF-β1 in left ventricular hypertrophy group were significantly higher than those without left ventricular hypertrophy group,the differences were statistically significant(P<0.05).The observation group was divided into three subgroups according to UAER,the levels of IGF-1 and TGF-β1 in the clinical albuminuria group and microalbuminuria group were significantly higher than those in the normal group,and the clinical albuminuria group was significantly higher than the microalbuminuria group,the differences were statistically significant(P<0.05).According to the correlation analysis of Spearman method,IGF-1 and TGF-β1 were positively correlated with IMT,LVMI and UAER levels(P<0.05).Conclusion The levels of IGF-1 and TGF-β1 in peripheral blood of hypertensive patients are closely related to cardiovascular remodeling and renal injury.Clinically,the levels of IGF-1 and TGF-β1 can be monitored so as to better prevent the impairment of heart,kidney and other organs function in patients with hypertension.