原发性高血压患者11β-类固醇脱氢酶2活性与肾素关系

Study on the relationship between 11β-steroid dehydrogenase 2 activity and renin in patients with essential hypertension

目的研究原发性高血压患者11β-类固醇脱氢酶2(11β-hydroxysteroid dehydrogenase type 2,11β-HSD2)活性与肾素的关系,为了解11β-HSD2在原发性高血压发病中的作用及探讨原发性高血压的发病机制提供新的线索。方法随机选取佳木斯大学附属第一院2018年10月至2019年7月间高血压门诊就诊和住院的原发性高血压患者113例为EH组,其中男性64例,女性49例,平均年龄为(49.79±13.75)岁。随机选取门诊健康体检者121例为对照组,其中男性67例,女性54例,平均年龄为(47.38±12.76)岁。同时采用磁微粒化学发光法、高效液相色谱法(HPLC)分别检测血浆肾素浓度、尿液中氢化可的松、可的松浓度。结果 (1)EH组肾素水平显著低于对照组(P=0.013)。而EH组F/E值与对照组相比,无显著差异(P=0.519)。(2)低肾素型EH患者F/E值与对照组和高肾素型EH患者相比,显著增高(P<0.05),表明低肾素型EH患者11β-HSD2活性显著降低。(3)F/E比值与肾素之间存在负相关关系(r=-0.797,P=0.000),表明原发性高血压患者11β-HSD2活性与肾素关系呈正相关。结论原发性高血压患者血浆肾素水平降低,肾素水平与11β-HSD2活性呈正相关,11β-HSD2在原发性高血压发病中可能有重要的作用。

Objective To study the relationship between 11β-steroid dehydrogenase 2 activity and renin in patients with essential hypertension,so as to provide new clues for understanding the role of 11β-HSD2 in the pathogenesis of essential hypertension and to explore the pathogenesis of essential hypertension.Methods 113 patients with primary hypertension from the Hypertension Clinic of the First Affiliated Hospital of Jiamusi University from October 2018 to July 2019 were selected as EH group,including 64 males and 49 females,with an average age of(49.79±13.75)years old.121 out-patient health checkups were randomly selected as the control group,including 67 males and 54 females,with an average age of(47.38±12.76)years.At the same time,the magnetic particle chemiluminescence method and high performance liquid chromatography(HPLC)were used to detect plasma renin concentration,hydrocortisone,and cortisone concentration in urine,respectively.Results(1)The renin level in the EH group was significantly lower than that in the control group(P=0.013).Compared with the control group,the F/E value of the EH group was not significantly different(P=0.519).(2)The F/E value of patients with low renin type EH was significantly higher than that of the control group and patients with high renin type EH(P<0.05),indicating that 11β-HSD2 activity of patients with low renin type EH was significantly reduced.(3)There was a negative correlation between F/E ratio and renin(r=-0.797,P=0.000),indicating that the relationship between 11β-HSD2 activity and renin was positive in patients with essential hypertension.Conclusion Plasma renin levels were reduced in patients with essential hypertension,and renin levels were positively correlated with 11β-HSD2 activity,11β-HSD2 may play an important role in the pathogenesis of essential hypertension.