血清胰岛素样生长因子-1和一氧化氮水平与原发性高血压关系的临床研究

目的探讨血清胰岛素样生长因子-1（IGF-1）及一氧化氮（NO）水平与原发性高血压（EH）及左心室肥厚（LVH）的关系。方法入选EH患者100例,为初次尚未服药治疗或服药后但血压控制不满意者,分为1、2、3级,计算左心室重量指数（LVMI）,LVMI〉125 g/m2（男）或〉120 g/m2（女）,为LVH。分为LVH（46例）组和无LVH（54例）组。另40例健康体检者作为对照组。分别用放射免疫法测定血清IGF-1及硝酸还原酶法测定血清NO水平。100例EH患者降压治疗3月后再次测定血压与血清IGF-1水平。结果 EH患者血清IGF-1水平（358.6±52.6）ng/ml高于正常对照组（142.5±41.3）ng/ml,血清NO水平（41.5±23.7）μmol/L低于对照组（82.1±20.8）μmol/L。EH组血压1-3级间血清IGF-1的水平（分别为257.6±45.3、329.4±32.8、412.3±41.5 ng/ml）随着EH级数的增加而增加且不同级数之间差异有统计学意义,NO的水平（分别为63.4±15.2、48.5±19.8、32.5±21.6μmol/L）随着EH级数的增加而降低且不同级数之间差异有统计学意义。EH伴LVH者血清IGF-1水平（387.4±35.8）ng/ml高于无LVH者（296.6±40.2）ng/ml,血清NO水平（34.3±18.2）μmol/L低于无LVH者（57.9±22.2）μmol/L。EH组经药物治疗3月后血压达标者的血清IGF-1水平（259.2±42.6）ng/ml低于血压未达标者（324.6±37.2）ng/ml,血清NO水平（75.6±12.9）μmol/L高于血压未达标者（46.2±15.3）μmol/L。结论 EH患者IGF-1升高,NO降低,可能参与高血压LVH的调节。其水平可以较好地反映LVH的程度。

Clinical Research on Correlation Between Essential Hypertension and the Levels of Serum Insulin Growth Factor - 1 and Nitric Oxide

Objective To explore the relationship between the serum levels of IGF-1 and nitric oxide with essential hypertension and left ventricular hypertrophy. Methods One hundred EH patients without initial treatment or with unsatisfactory blood pressure(EH grades I,II and III) after the therapy were recruited and divided into LVH group(n=46) and non-LVH group(n=54).40 physical examinees were served as control group.The serum level of IGF-1 was detected by radioimmunoassay and the serum level of NO was determined using nitrate reductase method.After three months of treatment,the serum levels of IGF-1 and NO of 100 EH patients were measured. Results The serum level of IGF-1(358.6±52.6 ng/ml) in patients with EH was significantly higher than that(142.5±41.3 ng/ml) in normal controls,but the serum level of NO(41.53±23.7 μmol/L) was lower than that(82.1±20.8 μmol/L) of normal controls.There were statistically significant differences in the serum levels of IGF-1(257.6±45.3 ng/ml,329.4±32.8 ng/ml,412.3±41.5 ng/ml) and NO(63.4±15.2 μmol/L,48.5±19.8 μmol/L,32.5±21.6 μmol/L) among the EH grades I,II and III.The serum level of IGF-1 was higher in EH with LVH(387.4±35.8 ng/ml) than EH without LVH(296.6±40.2 ng/ml),while the serum level of NO was lower in EH with LVH(34.3±18.2 μmol/L) than EH without LVH(57.9±22.2 μmol/L).After 3 months of treatment,the serum level of IGF-1 decreased more significantly in patients with normal blood pressure(259.2±42.6 ng/ml) than in patients with abnormal blood pressure(324.6±37.2 ng/ml),while the serum level of NO increased more significantly in patients with normal blood pressure(75.6±12.9 μmol/L) than in patients with abnormal blood pressure(46.2±15.3 μmol/L). Conclusions The increased level of serum IGF-1 and decreased level of serum NO may be interacted and involved in the regulation of LVH in patients with EH.IGF-1 and NO may play the important roles in the occurrence and development of LVH.