原发性高血压合并左心室肥厚患者血清sRAGE、MLT水平及其临床意义研究

目的探讨原发性高血压合并左心室肥厚(LVH)患者血清可溶性糖基化终产物受体(sRAGE)、褪黑素(MLT)水平及其临床意义。方法选择96例原发性高血压合并LVH患者(LVH组)和104例原发性高血压未合并LVH患者(NLVH组),检测血清sRAGE、MLT水平,并进行超声心动图检查。结果LVH组血清sRAGE、MLT水平低于NLVH组,差异有统计学意义(P<0.05)。相关性分析结果显示,LVH组血清sRAGE、MLT水平与左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室质量指数(LVMI)、左心室Tei指数呈负相关(P<0.05),与心室短轴缩短率(LVFS)、左心室射血分数(LVEF)、左心室舒张早期充盈峰最大充盈速度/舒张晚期充盈峰最大峰值速度(A/E值)呈正相关(P<0.05)。Logistic二元逐步回归分析结果显示,高收缩压、高LVMI、低sRAGE、低MLT是原发性高血压患者发生LVH的危险因素(P<0.05)。结论血清sRAGE、MLT水平降低可能与原发性高血压患者合并LVH的发生、左心室重构、左心功能下降有关。

Serum sRAGE,MLT levels and their clinical significance in patients with essential hypertension complicated with left ventricular hypertrophy

Objective To investigate the serum levels of soluble receptor advanced glycation end product(sRAGE)and melatonin(MLT)in patients with essential hypertension complicated with left ventricular hypertrophy(LVH)and their clinical significance.Methods A total of 96 patients with essential hypertension combined with LVH(LVH group)and a total of 104 patients without essential hypertension combined with LVH(NLVH group)were selected.Serum sRAGE and MLT levels were detected and echocardiography was performed.Results Serum sRAGE and MLT levels in LVH group were lower than those in NLVH group,and the differences were statistically significant(P<0.05).Correlation analysis showed that serum sRAGE and MLT levels in LVH group were negatively correlated with left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular mass index(LVMI),left ventricular Tei index(P<0.05),while positively correlated with left ventricular short axis shortening(LVFS),left ventricular ejection fraction(LVEF),maximum filling velocity of early diastolic peak/maximum filling velocity of late diastolic peak(A/E value)(P<0.05).Logistic binary stepwise regression analysis showed that high systolic blood pressure,low sRAGE and low MLT were risk factors for LVH in patients with primary hypertension(P<0.05).Conclusion The decrease of serum sRAGE and MLT levels may be related to the occurrence of LVH,left ventricular remodeling and left ventricular function decline in patients with essential hypertension.