老年高血压患者血压波动与血管活性物质的相关性

目的探讨老年原发性高血压(EH)患者血压波动与血管活性物质之间的关系。方法35例老年EH患者,血压正常时和血压波动时各抽取静脉血一次,放射免疫法检测肾上腺素(E)、去甲肾上腺素(NE)、内皮素(ET)、血管紧张素Ⅱ(AngII)和降钙素基因相关肽(CGRP)水平,同时检测33例健康老年人群各因子水平,比较EH患者血压波动前后各因子水平的差异和血压正常范围时两组人群各因子水平差异,分析不同状态下血压和各因子水平之间的相关性。结果老年EH患者血压波动时ET、AngII、E和NE的含量明显升高。CGRP的含量明显下降；两组人群在血压正常范围时各因子水平差异无显著性。相关性分析显示：老年EH患者血压波动时收缩压与ET、AngII和E呈正相关(r=0．304,0．337,0．587,P=0．031,0．019,0．036),与CGRP呈负相关(r=-0．416,P=0．028)；舒张压与AngII和E呈正相关(r=0．357,0．333；P=0．039．0．028)；血压波动时ET与AngII和E呈正相关(r=0．361,0．315；P= 0．041,0．029)。结论老年EH患者血压波动时各血管活性物质含量变化显著,其中以缩血管物质升高为主,血管活性物质在血压升高过程中起了关键作用。

Relationship between vasoactive substance and blood pressure in old patients with hypertension

Objective To observe the relationship between vasoactive substances and blood pressure in old patients with hypertension.Method Venous blood was drawn from 35 old hypertension patients when blood pressure was normal and abnormal,respectively.Epinephrine(E),norepinephine(NE),endothelins(ET),angiotensin ll (Angll) and ealcitonin-gene-retated peptide were determined by radio-immunity.The above five cytokines were also determined in 33 old healthy people.The cytokines levels were compared between the normal and abnormal blood pressure in hypertension patients and also between the old hypertension patients and healthy persons.The correlation between blood pressure and cytokines were analyzed.Results The level of ET,Angll,E and NE were obviously increased in old hypertension patients when their blood pressure was abnormal,while CGRP obviously decreased.No difference was found in the five cytokines between two groups when the blood pressure were normal.The correlation analysis showed that systolic pressure had positive correlation with ET,AnglI and E(r=0.304,0.337,0.587,P=0.031,0.019,0.036)and negative correlation with CGRP(r=-0.416,P=0.028)in old hypertension patients when the blood pressure was abnormal.And the diastolic pressure had positive correlation with AnglI and E(r=0.357,0.333;P=0.039,0.028).ET had positive correlation with Angll and E(r=0.361,0.315;P=0.041,0.029).Conclusion The levels of vasoaetive substances significantly changed in old hypertension patients with the blood pressure change.Among those cytokines,the substances that contract blood vessel increased most obviously.The vasoactive substances played an important role in the progress of blood pressure rising.