高血压患者血压节律与血管活性物质相关性研究

Relationship between vascular active substances and blood pressure rhythm in patient with essential hypertension

目的观察高血压患者血压昼夜节律异常的病理生理变化特征,探讨高血压患者血管活性物质与血压昼夜节律的相关性。方法93例高血压患者进行动态血压监测和血栓素A2(TXA2)、前列环素(PGI2)、神经肽Y(NPY)、降钙素基因相关肽(CGRP)测定。结果93例高血压患者按动态血压监测结果分为杓型、非杓型组,在非杓型组中,TXA2、NPY明显增高(TXA2:P<0.01,NPY:P<0.05),PGI2,CGRP明显降低(P均<0.001);且夜间血压下降与TXA2、NPY呈负相关(TXA2:SBP:r=-0.254,P<0.05,DBP:r=-0.229,P<0.05;NPY:SBP:r=-0.277,P<0.01,DBP:r=-0.245,P<0.05),与PGI2,CGRP正相关(PGI2:SBP:r=0.302,P<0.005,DBP:r=0.324,P<0.005;CGRP:SBP:r=0.289,P<0.01,DBP:r=0.332,P<0.01)。多元线性回归分析:TXA2,PGI2,NPY与夜间收缩压下降直线相关(F=7.554,P<0.001),TXA2,PGI2,CGRP与夜间舒张压下降直线相关(F=7.242,P<0.001)。结论高血压患者TXA2,PGI2,NPY,CGRP可能参与血压昼夜节律的调节。

Aim There have not definite conclusion about pathophysiological mechanism of abnormal circadian rhythm of blood pressure,we would evaluate relationship between vascular active substances and circadian rhythm of blood pressure in patient with essential hypertension.Methods 93 patients with essential hypertension were monitored 24 h blood pressure and examined thromxane A2(TXA2),prostacyclin(PGI2),neuropeptide Y(NPY), calcitonin gene related peptide( CGRP) .Results According to results of the monitoring,93 hypertensive patients were divided dipper hypertension and non dipper hypertension.In non dipper, TXA2,NPY was significantly higher(TXA2: P< 0.01,NPY:P< 0.05),PGI2,CGRP was lower (P< 0.001).There were significantly negative correlation between nocturnal blood pressure fall and TXA2, NPY(TXA2: SBP: r=- 0.254, P< 0.05,DBP:r=- 0.229,P< 0.05; NPY:SBP r=- 0.277,P< 0.01,DBP:r=- 0.245,P< 0.05),positive correlation between nocturnal blood pressure fall and PGI2,CGRP(PGI2:SBP:r=0.302,P< 0.005,DBP:r=0.324,P< 0.005;CGRP:SBP:r=0.289,P< 0.01,DBP:r=0.332,P< 0.01).On multipleregression analysis, TXA2,PGI2,NPY were steeply related to nocturnal systolic blood pressure (SBP)fall(F=7.554, P< 0.001), TXA2,PGI2,CGRP were steeply related to nocturnal diastolic blood pressure(DBP)fall(F=7.242, P< 0.001) .Conclusion TXA2,PGI2,NPY and CGRP might have effects in circadian rhythm of blood pressure in essential hypertension.<P>