阿托伐他汀对原发性高血压左室肥厚患者血浆妊娠相关蛋白-A的影响

目的探讨血浆妊娠相关蛋白-A(PAPP-A)与原发性高血压(EH)左室肥厚(LVH)的关系及阿托伐他汀对炎性因子的干预作用。方法 EH患者49例,行心脏彩色超声检查,测量室间隔厚度(IVST)、左室后壁厚度(LVPWT)及左室舒张末内径(LVDD),计算左室质量指数(LVMI)。根据LVH的诊断标准将EH患者分为高血压伴左心室肥厚组(观察组)和高血压无左心室肥厚组(对照组)。2组均给予阿托伐他汀干预,运用双抗体夹心酶联免疫吸附法(ELISA)测定治疗前后血浆PAPP-A浓度。结果治疗前观察组PAPP-A、IVST、LVPWT、LVMI均高于对照组,差异有统计学意义(P<0.05)。与治疗前相比,观察组治疗后PAPP-A及LVMI、IVST、LVPWT显著降低,但仍高于对照组(P均<0.05)。经Pearson分析,PAPP-A与LVMI呈显著正相关(r=0.547,P<0.05)。结论 EH伴LVH患者PAPP-A显著升高,并且PAPP-A与LVMI呈正相关,阿托伐他汀可降低PAPP-A水平。

The influence of atorvastatin on pregnancy associated plasma protein-A in essential hypertension patients with left ventricular hypertrophy

Objective To investigate the relationship between pregnancy associated plasma protein-A（PAPP-A） and essential hypertension（EH） patients with left ventricular hypertrophy（LVH）,and interventional effect of atorvastatin on the inflammatory factors.Methods 49 patients with EH underwent echocardiography examination to determine the inter ventricular septum thickness（IVST）,left ventricular posterior wall thickness（LVPWT） and left ventricular diastolic diameter （LVDD）,also calculate the left ventricular mass index（LVMI）.These patients then divided into LVH group and non LVH group according to the diagnostic criteria of left ventricular hypertrophy.Both the LVH group and non LVH group were treated with atorvastatin.The level of PPAP-A pre-and post-treatment were detected by double antibody sandwich Enzyme linked immunosorbent assay（ELISA）.Results The level of PAPP-A,IVST,LVPWT and LVMI were higher in the LVH group than non LVH group before treatment（P0.05）.After treatment,the level of PAPP-A,LVMI,IVST and LVPWT were decreased obviously compared with pre treatment,but still higher than control group（all P0.05 ）.The Pearson analysis shows that PAPP-A and LVMI was closely correlated（r =0.547,P0.05）.Conclusion The level of PAPP-A were higher in the LVH group than non LVH.PAPP-A and LVMI were positively correlated.Atorvastatin can reduce the level of PAPP-A and reverse myocardial remodel by inhibiting inflammatory factors.