老年高血压病患者肾素系统和血管活性肽的变化

目的 :探讨老年原发性高血压 （EH ）患者肾素 （RA） -血管紧张素 （AT） -醛固酮 （AL D）系统 （RAAS）及心房钠尿肽 （ANP）、内皮素 （ET）、降钙素基因相关肽 （CGRP）等血管活性肽的变化。方法 :放射免疫方法检测 96例健康老年人和 10 4例老年 EH患者血浆肾素活性 （PRA） ,AT ,AL D,ANP,ET,CGRP浓度。结果 :1两组 PRA,AT ,AL D浓度均随年龄增长而降低 （P<0 .0 5或 P <0 .0 1） ,但老年 EH患者明显高于健康老年人 （P<0 .0 5或 P<0 .0 1） ;2健康老年人各年龄组的 ANP,ET和 CGRP无明显差异 （P>0 .0 5 ） ;老年 EH患者血浆 ANP,ET浓度随年龄增长而明显增高 （P<0 .0 5或 P<0 .0 1） ,CGRP浓度随年龄增长而明显减低 （P<0 .0 1） ;各年龄组老年 EH患者血浆 ANP,ET均明显高于健康老年人 （P<0 .0 5或 P<0 .0 1） ,CGRP浓度均明显低于健康老年人 （P<0 .0 5或P<0 .0 1）。 3老年 EH患者血浆 AT 与 ANP,ET呈正相关 （r=0 .6 0 ,0 .79,P<0 .0 1） ,与 CGRP呈负相关 （r=-0 .5 9,P<0 .0 1）。结论 :老年人随着年龄的增长 ,在生理状态下传统的 RAAS的作用减弱 ,更多的是血管活性肽（ANP,ET,CGRP）参与心血管活性的调节 ,老年 EH患者缩血管肽 ET的活性增高、舒血管肽 CGRP活性减弱。

Changes of plasma concentrations in renin system and some vasoactive peptides in aged hypertension patients

AIM:To investigate the changes of plasma concentrations of renin (PRA)-angiotensin (ATⅡ)-aldostrone(ALD) system(RAAS) and some plasma vasoactive peptides,atrial natriuretic (ANP),endothelin (ET) and calcitonin gene-related peptide(CGRP),in aged normal and hypertension patients. METHODS:To determine the plasma concentrations of PRA,ATⅡ,ALD,ANP,ET and CGRP in 96 normal controls and 104 hypertension patients with radioimmunoassay. RESULTS:The plasma concentrations of PRA,ATⅡ and ALD were decreared with age increasing both in the normal controls and in the hypertension patients(P<0.05 or P<0.01),but those of hypertension patients were significantly higher than those of the normal controls(P<0.05 or P<0.01). There were no obvious differences of ANP,ET and CGRP concentrations in different age groups of the normal controls(P>0.05);the plasma concentrations of ANP and ET in hypertension patients were apparently increased with age (P<0.05 or P<0.01), and that of CGRP was decreased (P<0.01);the plasma concentrations of ANP and ET in different age groups of hypertension patients were significantly higher than those of the normal control (P<0.05 or P<0.01) and those of CGRP were lower than those of the normal controls (P<0.05 or P<0.01). There was a positive correlation between ATⅡ and ANP,as well as between ATⅡ and ET (r=0.60,0.79,P<0.01) and there was a negative correlation between ATⅡ and CGRP (r=-0.59,P<0.01) in hypertension patients. CONCLUSION:In physiolgoical state,the action of traditional RAAS on blood pressure might be decreased with age in aged people,and the vasoactive peptides (ANP,ET,CGRP) might contribute more to the cardiovascular action to keep blood pressure stable. Activity of vasoconstrictive peptides(ATⅡ,ET) were incresaed and activity of vasodilative peptide(CGRP) was decreased.