一氧化氮内皮素与高血压病左室肥厚的相关研究

目的 :探讨一氧化氮 (NO)、内皮素 (ET)的变化与高血压病左室肥厚 (LVH)的关系。方法 :高血压组 6 7例 (其中伴左室肥厚者 30例 ) ,正常对照组 30例 ,以放免法测定血浆ET、硝酸还原酶法经比色测算血清NO ,彩色多普勒超声测定左室结构和功能。结果 :高血压(EH)组血浆ET水平高于对照组 ,血清NO水平低于对照组 (P均 <0 0 1) ,EH伴LVH组ET水平高于NO水平低于不伴LVH组 (P均 <0 0 1) ;左室重量指数 (LVMI)与ET、血压水平呈正相关 (r分别为 :0 4 19、0 4 79,P均 <0 0 1) ,与NO水平呈负相关 (r =- 0 4 93,P <0 0 1)。多元逐步回归分析显示 :ET对LVH作用显著 (r =0 6 6 0 ,P <0 0 1)。EH早期就有左室舒张功能受损 ,出现LVH时 ,舒张功能损害加重。结论 :NO、ET对高血压及左室肥厚形成有一定作用。LVH影响心脏的舒、缩功能

The Relationship Between Left Ventricuiar Hypertrophy and Plasm Endothlin and Nitric Oxide in Essential Hypertension

Objective:To investigate the relationship between the plasm endothelin (ET) and nitric oxide (NO) and the left ventricular hypertrophy(LVH) in essential hypertension (EH).Methods:67 EH patients(30 with LVH) and 30 normotensive controls (NC) were studied.Plasm ET level were detected by radioimmunoassay (RIA) method and serum NO level by colorimeteric,color doppler echocardiography were used to study left ventricular structure and function.Results:The plasm ET level in EH patients was higher and serum NO was lower than those in NC groups (all P<0 01).ET was higher and serum NO was lower in EH patients with LVH than those in patients without LVH(all P<0.01).Plasm ET and blood pressure were positively correlated with left ventricular mass index(LVMI)(r=0.42,r=0.48,respectively,all P<0.01),the level of NO was negative correlated with LVMI (r=-0.49,P<0.01).Multiple stepwise regression analysis revealed that ET was the most important factors affecting LVH (r=0.66,P<0.01).Left ventricular diastlic function was damaged in EH early stage,this changes were more obvious in EH with LVH.Conclusion:ET and NO may play an important role in the causes of the hypertension and LVH.LVH affect left ventricular diastolic and systolic function.