原发性高血压患者清晨血压升高与血浆内皮素和血管紧张素Ⅱ的相关性研究

目的探讨原发性高血压患者清晨血压升高与血浆内皮素(ET)、血管紧张素Ⅱ(AngⅡ)的关系。方法选取原发性高血压患者180例根据清晨血压是否升高分为晨峰组(MBPS组,83例)和非晨峰组(Non-MBPS组,97例)。用放射免疫法测定两组的血浆ET和AngⅡ水平,分析两组间的血浆ET和AngⅡ水平差异,并分别分析两组中的血浆ET、AngⅡ水平与24 h动态血压监测结果的相关性。结果 MBPS组血浆ET、AngⅡ水平〔(82.53±12.24),(78.82±32.47)pg/ml〕高于Non-MBPS组〔(75.56±3.74),(59.34±31.72)pg/ml〕,差异有统计学意义(P<0.05)。在MBPS组中,血浆ET与24 h平均舒张压、白昼平均舒张压、夜间平均舒张压、清晨舒张压增高值、清晨(6:00～10:00)平均舒张压呈正相关性;血浆AngⅡ与24 h平均收缩压、白昼平均收缩压、夜间平均收缩压、清晨收缩压增高值、清晨(6:00～10:00)平均收缩压呈正相关性。Non-MBPS组血浆ET、AngⅡ与24 h动态血压监测结果各参数差异无统计学意义。结论原发性高血压患者中MBPS组血浆ET、AngⅡ水平明显高于Non-MBPS组。血浆ET、AngⅡ水平可能与清晨血压升高相关。

Association of Plasma Endothelin/Angiotensin Ⅱ and Morning Blood Pressure Surge in Patients with Essential Hypertension

Objective To investigate the relationship between plasma endothelin(ET)/angiotensin Ⅱ(AngⅡ) and morning blood pressure surge(MBPS)in patients with essential hypertension.Methods Totally 180 patients with essential hypertension were divided into MBPS group(n=83)and Non-MBPS group(n=97)according to their morning blood pressure.The plasma ET and AngⅡ were detected using radio-immunoassy,and the correlation between plasma ET/AngⅡand 24-h diastolic blood pressure(DBP) were analyzed.Results Plasma ET and AngⅡ levels in MBPS group((82.53±12.24) mmol/L,(78.82±32.47)mmol/L,respectively) were significantly higher than those in the Non-MBPS group((75.56±3.74) mmol/L,(59.34±31.72) mmol/L,respectively)(P<0.05).There was positive correlation between plasma ET and 24h DBP,daytime DBP,nocturnal DBP,MDBP,and sleep-trough MS DBP in MBPS group.There was positive correlation between plasma AngⅡand 24 h SMP,daytime SMP,nocturnal SMP,morning SMP,and sleep-trough MS SMP in MBPS group.Plasma ET/AngⅡ showed no correlation with the 24-hour ambulatory blood pressure monitoring in Non-MBPS group.Conclusion Plasma ET and AngⅡ may be involved in MBPS.