原发性高血压左室肥厚患者妊娠相关血浆蛋白-A和C-反应蛋白的变化

目的：探讨原发性高血压（EH）左室肥厚（LVH）患者血浆妊娠相关蛋白-A（pregnancy-associated plasma protein-A，PAPP-A）和C-反应蛋白（Creactive protein，CRP）的变化。方法：EH患者49例，行心脏彩色超声检查，测量室间隔厚度（IVST）、左室后壁厚度（LVPWT）及左室舒张末内径（LVDD），计算左室质量指数（LVMI）。根据LVH的诊断标准将EH患者分为LVH＋组和LVH一组。运用双抗体夹心酶联免疫吸附实验（EALAS法）测定血浆PAPP-A浓度和运用双抗体放射免疫法检测血浆高敏CRP（hs-CRP）浓度。结果：LVH＋组PAPP—A及hs-CRP均高于LVH-组分别为8．28（5．90～30．91）mIU／L vs 4．39（3．02～6．98）n1IU／L和8．58（0．90～35．80）mg／L vs 1．90（0．50～2．23）mg／L，P均〈0．05J。PAPP-A与LVMI及hs-CRP与LVMI的相关分析显示：PAPP-A与LVMI呈显著正相关（r=0．649，P〈0．05），hs-CRP与LVMI呈显著正相关（r=0．441，P〈0．05）。结论：EH伴LVH患者PAPP-A及CRP较LVH-组显著升高，并且PAPP-A、hs-CRP与LVMI呈显著正相关。PAPP—A与CRP可能参与EH患者LVH的形成。PAPP—A与CRP可能是EH患者合并LVH的预测指标。

Variations of pregnancy-associated plasma protein-A and C- reactive protein in essential hypertension patients with left ventricular hypertrophy

AIM: To investigate the variation of pregnancy-associated plasma protein-A (PAPP-A) and C-reactive protein ( CRP) in essential hypertension (EH) patients with left ventricular hypertrophy(LVH). METHODS: 49 patients with EH were examined by echocardiography to measure the inter-ventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular diastolic diam-eter(LVDD) ,and to calculate the left ventricular mass index (LVMI). The patients were divided into the left ventricular hypertrophy (LVH) group and the non-LVH group according to the diagnostic criteria of left ventricular hypertrophy . The levels of PPAP-A were detected by double-antibody sandwich enzyme-linked immu-nosorbent assay (ELISA) and the levels of hs-CRP were performed by double antibody radioimmunoassay. RESULTS: The levels of PAPP-A and hs-CRP were higher in the LVH group than the non-LVH 8.28 (5.90 ～ 30.91) mIU/L vs 4.39(3.02～ 6.98) mIU/L, 8.58(0.90～35.8) mg/L vs 1.90(0.50～ 2.23) mg/L, P all <0.05]. The relevant analysis showed that PAPP-A and LVMI were significantly correlated ( r = 0.649, P < 0.05); hs-CRP and LVMI were significantly correlated (r = 0.441, P < 0.05). CONCLUSION: The levels of PAPP-A and hs-CRP were higher in the LVH group than those in the non-LVH group. PAPP-A and LVMI are positively correlated, hs-CRP and LVMI are also positively correlated. PAPP-A and CRP may be involved in the formation of LVH in patients with EH. PAPP-A and CRP may be as predictors of the EH patients with LVH.