高龄老年患者原发性高血压分期和血压控制效果与血管活性物质和血脂水平的关系

目的:观察和分析高龄老年患者原发性高血压(EH)分期和不同控制状态与血浆血管活性物质及血脂水平的关系。方法:80岁以上离退休人员60例为研究对象,分为Ⅰ,Ⅱ,Ⅲ期,血压控制理想组与不理想组。应用放射免疫法测定血浆肾上腺髓质素(ADM)、内皮素(ET)、心房钠尿肽(ANP)和血管紧张素Ⅱ(AngⅡ)的水平,硝酸还原酶法测定NO。血脂采用酶试剂法,免疫浊度法。结果:EHⅠ期AngⅡ显著升高,EHⅡ期ADM,ET,ANP显著升高,NO显著降低。EHⅢ期ADM,ET,ANP,AngⅡ较Ⅱ期显著升高,NO较Ⅰ,Ⅱ期显著降低。理想组NO,ANP,AngⅡ较对照组无显著差异,理想组较不理想组ADM,NO,ET,ANP有显著差异。血脂指标在各组间无显著差异。结论:血管活性物质的水平可作为临床分期与评价治疗效果的指标之一。

Effect of stages of essential hypertension and blood pressure control on endovascular active substance and blood lipid level in elderly subjects

AIM: To observe and analyze the effect of essential hypertension (EH) stages and results of blood pressure control on endovascular active substance and blood-lipid level in seniors. METHODS: Sixty elderly, retired subjects aged >80 years were divided into five groups: I-period group, II-period group, III-period group, ideal blood pressure control group and non-ideal blood pressure control group. Radioimmunization was used to measure levels of ADM, ET, ANP and AngII, and nitric acid reductase was used to measure NO. Blood lipid level was tested enzymatically method and with the turbidimetric immunoassay method. RESULTS: AngII of EH I period rose significantly. ADM, ET and ANP of EH II period rose but NO dropped significantly. ADM, ET, ANP, AngII of EH III period rose significantly compared with those of EH II period. NO of EH III period decreased significantly compared with that of I and II periods. NO, ANP and AngII of ideal blood pressure control group were not significantly different from those in the control group, but ADM, NO, ET and ANP in the ideal group were significantly different from those in the non-ideal blood pressure control group. No significant difference was found in blood lipid levels among all groups. CONCLUSION: The level of endovascular active substance can be used as one of the indices to establish clinical stages and evaluate curative effects.