超声心动图评价高血压左心室舒张功能变化及其与血清脂联素和可溶性细胞黏附分子1的相关性

目的观察原发性高血压(EH)患者血清脂联素(APN)和可溶性细胞黏附分子1(sICAM-1)的水平变化,分析APN和sICAM-1与EH左心室舒张功能变化之间的关系。方法采用酶联免疫吸附(ELISA)法测定高血压1级、2级、3级患者各41例、及35例正常对照者血清APN及sICAM-1浓度,同时检测血糖、血脂、血尿常规等相关指标;并用超声心动图测量各组左心室舒张末期内径(LVEDd),左心室后壁厚度(LVPWT),舒张末期室间隔厚度(IVST),并计算左心室质量指数(LVMI)。根据血流频谱测定二尖瓣瓣尖舒张早期最大血流速度(E峰)、晚期最大血流速度(A峰)并计算E/A比值。结果 EH患者血清APN浓度(3.56±1.27)ng/L低于正常对照组(4.98±1.12)ng/L(P0.05),其中高血压1级患者血清APN水平(4.55±0.93)ng/L显著高于高血压3级患者(2.62±0.96)ng/L(P0.01)。EH患者血清sICAM-1浓度(6.10±1.89)μg/L显著高于正常对照组(3.22±1.53)μg/L(P0.01),且随高血压分级的升高而升高。相关分析显示LVMI与血清APN呈负相关(r=-0.448,P0.01),sICAM-1与血清APN呈负相关(r=-0.484,P0.01)。结论血清APN及sICAM-1可能参与高血压病理发展过程;监测两者浓度为临床评估高血压病变程度及预后提供了一项重要信息;LVMI是影响血清APN水平的独立影响因素。

Echocardiography evaluation on correlation between left ventricular diastolic function and serum adiponectin along with soluble intercellular adhesion molecule-1 in hypertensive patients

Objective To observe the change of serum adiponectin（APN）and soluble intercellular adhesion molecule-1（sICAM-1）in patients with essential hypertension（EH）,and analyze the relationship of APN and sICAM-1with EH left ventricular diastolic function.Methods By using the enzyme-linked immunosorbent assay（ELISA）,we measured the concentration of serum APN and sICAM-1,and related indexes of blood glucose,blood lipid,blood and urine routine in patients with hypertension grades 1,2,and 3,in which each grade had 41 cases,and 35 normal controls;echocardiography was used to measure left ventricular end-diastolic diameter（LVEDd）,left ventricular posterior wall thickness（LVPWT）,end-diastolic chamber interval thickness（IVST）of each group,and calculated left ventricular mass index（LVMI）.Doppler parameters were used to measure the blood flow in sharp early diastolic mitral flow velocity maximum（E）,late Vmax（A）and calculate E/A ratio.Results Serum APN（3.56±1.27）ng/L in patients with EH was lower than that of normal control group（4.98±1.22）ng/L（P〈 0.05）.Serum level of APN in patients with hypertension stage 1（4.55±0.93）ng/L was significantly higher than that in patients with hypertension stage 3（2.62±0.96）ng/L（P〈 0.01）.The concentration of serum sICAM-1in patients with EH（6.10±1.89）μg/L was significantly higher than that of normal control group（3.22±1.53）μg/L（P〈0.01）,and it rose with the increase of hypertension grade.Correlation analysis showed that LVMI was negatively correlated with serum APN（r=-0.448,P〈 0.01）,and the serum sICAM-1was negatively correlated with APN,as well（r=-0.484,P〈0.01）.Conclusion APN and sICAM-1 may be involved in the pathogenesis of hypertension;the monitor of the two markers concentration provides the most important information for the clinical evaluation of the degree and prognosis of hypertension;LVMI affects APN level as an independent factor.