缬沙坦逆转原发性高血压患者左心室肥厚的相关因素

目的探讨血管紧张素Ⅱ1型受体(AT1)拮抗剂缬沙坦在治疗原发性高血压过程中对血清转化生长因子β1(TGF-β1)、基质金属蛋白酶-1(MMP-1)及其抑制剂(TIMP-1)水平的影响及其与逆转左心室肥厚(LVH)的关系。方法选择合并LVH的原发性高血压患者58例,给予缬沙坦治疗8个月,于治疗前后分别检测血中TGF-β1、MMP-1、TIMP-1水平及左心室重量指数(LVMI),进行对比分析。结果缬沙坦治疗后患者LVMI、血中TGF-β1水平较治疗前显著降低(均为P<0.01);MMP-1水平显著升高(P<0.05);TIMP-1水平有下降趋势,但与治疗前对比差异无统计学意义(P>0.05)。TGF-β1与MMP-1呈显著负相关(γ=-0.5571,P<0.01)。结论缬沙坦逆转原发性高血压患者左心室肥厚的作用可能与其降低TGF-β1、升高MMP-1水平有关;TGF-β1可能通过抑制MMP-1的表达来促进LVH的形成。

Investigation of relating factors in left ventricular hypertrophy reversion by valsartan in patients with essential hypertension

Objective To investigate the influence of valsartan(angiotension Ⅱ type I receptor antagonist) on the levels of serum transforming growth factor-beta1(TGF-β1),matrix metalloproteinase-1(MMP-1),tissue inhibitors of metalloproteinase-1(TIMP-1) in patients with essential hypertension(EH) and on reversing left ventricular hypertrophy(LVH).Methods The 58 patients with EH and LVH identified by Dopple echocardiography were treated with valsartan.Before and after treatment for 6 months,left ventricle mass index(LVMI) and serum levels of TGF-β1,MMP-1,TIMP-1 were obtained and analyzed respectively.Serum levels of TGF-β1 and MMP-1 and TIMP-1 were measured by sandwich assay-enzyme linked immunosorbent assay(ELISA) and indirect-ELISA respectively.Results LVMI value of patients was significantly decreased after treatment with valsartan(P<0.01),serum level of TGF-β1 was significantly decreased and level of MMP-1 was significantly increased correspondingly(P<0.01 and P<0.05 respectively).Level of TGF-β1 was negatively correlated with level of MMP-1(γ=-0.5571,P<0.01).Conclusions TGF-β1 may inhibit the expression of MMP-1 and cause LVH in patients with EH and valsartan reverses LVH possibly by decreasing the expression of TGF-β1 and increasing the level of MMP-1.