原发性高血压左室肥厚患者妊娠相关血浆蛋白-A和C-反应蛋白的变化

中国临床药理学与治疗学 ›› 2009, Vol. 14 ›› Issue (2): 203-206.

原发性高血压左室肥厚患者妊娠相关血浆蛋白-A和C-反应蛋白的变化

范剑峰¹, 汤圣兴¹, 王俊², 朱卫平³, 李必龙¹, 朱正才¹

¹皖南医学院弋矶山医院心内科, ²皖南医学院心血管病研究所, ³检验科, 芜湖241001, 安徽

收稿日期:2008-08-17 修回日期:2008-11-26 出版日期:2009-02-26 发布日期:2020-10-30
通讯作者: 汤圣兴, 男, 博士, 教授, 硕士生导师, 从事冠心病介入治疗与研究。Tel:13955330717 　E-mail:tsx2229@163.com
作者简介:范剑峰, 男, 硕士生, 医师, 研究方向:冠心病介入治疗。Tel:13655539035 　E-mail:fjf2008250@sohu.com
基金资助:
安徽省教育厅自然科学研究项目(2006KJ116C);弋矶山医院博士基金资助

Variations of pregnancy-associated plasma protein-A and C-reactive protein in essential hypertension patients with left ventricular hypertrophy

FAN Jian-feng¹, TANG Sheng-xing¹, WAN Jun², ZHU Wei-ping³, LI Bi-long¹, ZHU Zheng-cai¹

¹Department of Cardiology, ²Department of Cadres, ³Department of Laboratory, Affiliated Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui, China

Received:2008-08-17 Revised:2008-11-26 Online:2009-02-26 Published:2020-10-30

摘要/Abstract

摘要： 目的:探讨原发性高血压(EH) 左室肥厚(LVH) 患者血浆妊娠相关蛋白-A(pregnancy-associated plasma protein-A, PAPP-A) 和C-反应蛋白(Creactive protein, CRP) 的变化。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LVH +组和LVH-组。运用双抗体夹心酶联免疫吸附实验(EALAS 法) 测定血浆PAPP-A 浓度和运用双抗体放射免疫法检测血浆高敏CRP(hs-CRP) 浓度。结果:LVH +组PAPP-A 及hs-CRP 均高于LVH-组[ 分别为8.28(5.90 ～ 30.91) mIU/Lvs 4.39(3.02 ～6.98) mIU/L 和8.58(0.90 ～ 35.80) mg/L vs 1.90(0.50 ～ 2.23) mg/L, P 均<0.05]。PAPP-A 与LVMI 及hs-CRP 与LVMI 的相关分析显示:PAPPA与LVMI 呈显著正相关(r =0.649, P <0.05), hs-CRP 与LVMI 呈显著正相关(r =0.441, P <0.05)。结论:EH 伴LVH 患者PAPP-A 及CRP 较LVH-组显著升高, 并且PAPP-A 、hs-CRP 与LVMI呈显著正相关。PAPP-A 与CRP 可能参与EH 患者LVH 的形成。PAPP-A 与CRP 可能是EH 患者合并LVH 的预测指标。

关键词: 原发性高血压, 左室肥厚, 妊娠相关蛋白-A, C-反应蛋白

Abstract: AIM: To investigate the variation of pregnancy-associated plasma protein-A (PAPP-A) and C-reactive protein (CRP) in essential hypertension (EH) patients with left ventricular hypertrophy(LVH). METHODS: 49 patients with EH were examined by echocardiography to measure the inter-ventricular septum thickness (IVST), left ventricular posterior wall thickness(LVPWT) and left ventricular diastolic diameter(LVDD), and to calculate the left ventricular mass index (LVMI).The patients were divided into the left ventricular hypertrophy (LVH) group and the non-LVH group according to the diagnostic criteria of left ventricular hypertrophy.The levels of PPAP-A were detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) and the levels of hs-CRP were performed by double antibody radioimmunoassay. RESULTS: The levels of PAPP-A and hs-CRP were higher in the LVH group than the non-LVH [ 8.28 (5.90 ～ 30.91) mIU/L vs 4.39 (3.02 ～ 6.98) mIU/L, 8.58(0.90 ～ 35.8) mg/L vs 1.90 (0.50 ～ 2.23) mg/L, P all <0.05].The relevant analysis showed that PAPP-A and LVMI were significantly correlated (r =0.649, P <0.05);hs-CRP and LVMI were significantly correlated (r =0.441, P <0.05). CONCLUSION: The levels of PAPP-A and hs-CRP were higher in the LVH group than those in the non- LVH group.PAPP-A and LVMI are positively correlated, hs-CRP and LVMI are also positively correlated. PAPP-A and CRP may be involved in the formation of LVH in patients with EH.PAPP-A and CRP may be as predictors of the EH patients with LVH

Key words: essential hypertension, left ventricular hypertrophy, pregnancy-associated plasma protein-A, C-reactive protein

中图分类号:

R541.4

范剑峰, 汤圣兴, 王俊, 朱卫平, 李必龙, 朱正才. 原发性高血压左室肥厚患者妊娠相关血浆蛋白-A和C-反应蛋白的变化[J]. 中国临床药理学与治疗学, 2009, 14(2): 203-206.

FAN Jian-feng, TANG Sheng-xing, WAN Jun, ZHU Wei-ping, LI Bi-long, ZHU Zheng-cai. Variations of pregnancy-associated plasma protein-A and C-reactive protein in essential hypertension patients with left ventricular hypertrophy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(2): 203-206.

参考文献

[1] Sung KC, Suh JY, Kim BS, et al.High sensitivity C-reactive protein as an independent risk factor for essential hypertension[J].Am J Hypertens, 2003, 16(6):429-433.
[2] Devereux RB, Alonso DR, Lutas EM, et al.Echocardiographic assessment of left ventricular hypertrophy:comparison to necropsy findings[J].J Am Cardiol, 1986, 57(6): 450-458.
[3] Lin TM, Halbert SP, Spellacy WN.Measurement of pregnancy-associated plasma proteins during human gestation [J].J Clin Invest, 1974, 54(3):576-582.
[4] Miles PD, Li S, Hart M, et al.Mechanisms of insulin resistance in experimental hyper-insulinemic dogs[J].J Clin Invest, 1998, 101(1):202-211.
[5] LawrenceJB, Oxvig C, Ovcrgaard MT, et al.The insulin-like growth factor (IGF) binding protein-4 protease secreted by human fibroblasts is Pregnancy associated plasma protein-A[J].Proc Natl Acad Sci USA, 1999, 96 (6): 3149-3153.
[6] Ren J, Jefferson L, Sowers J, et al.Influence of age on contractile response to insulin like growth factor 1 in ventricular myocytes from spontaneously hypertensive rats[J].Hypertension, 1999, 34(6):1215-1222.
[7] Devereux RB, Roman MJ, de Simone G.Relations of Left ventricular mass to demographic and hemodynamic variables in American Indians:the Strong Heart Study[J]. Circulation, 1997, 96(5):1416-1423.
[8] Bell D, Mc Dermott BJ.Contribution of de novo protein Synthesis to the hypertrophic effect of IGF-1 but not of Thyroid hormones in adult ventricular cardiomyocytes[J]. Mol Cel Biochem, 2000, 206(1/2):113-124.
[9] 汤圣兴, 祁述善, 周胜华.C 反应蛋白促进离体SHR大鼠血管平滑肌细胞的增殖[J].中国病理生理杂志, 2007, 23(4):706-709.
[10] Sesso HD, Buring JE, Rifai N, et al.C-reactive protein and the risk of developing hypertension[J].JAMA, 2003, 290(22):2945-2951.
[11] Salles GF, Fiszman R, Cardoso CR, et al.Relation of left ventricular hypertrophy with systemic inflammation and endothelial damage in resistant hypertension[J].Hypertension, 2007, 50(4):723-728.
[12] Blake GJ, Rifai N, Buring JE, et al.Blood pressure, Creactive protein, and risk of future cardiovascular events [J].Circulation, 2003, 108(24):2993-2999.
[13] 汤圣兴, 祁述善, 周胜华, 等.阿托伐他汀对自发性高血压大鼠心室重塑的作用及机制[J].中国病理生理杂志, 2006, 22(8):1535-1539.

[1]	陈娟燕，宋水江，徐冬娟，徐琼，李鸿飞. 法舒地尔联合瑞舒伐他汀治疗血管性痴呆对认知功能、C-反应蛋白及氧化应激的影响[J]. 中国临床药理学与治疗学, 2018, 23(10): 1153-1158.
[2]	金岳龙，王林红，朱丽君，梁伟，段滢,杨松，陈燕春，赵祥海，沈冲，姚应水. 一氧化氮合酶基因多态性与常用降压药疗效的关联研究[J]. 中国临床药理学与治疗学, 2017, 22(5): 538-544.
[3]	施六霞, 金岳龙, 王祥雨, 贺连平, 姚应水. 高血压、2型糖尿病并发牙周炎患者超敏C-反应蛋白及炎性细胞因子表达分析[J]. 中国临床药理学与治疗学, 2015, 20(5): 541-545.
[4]	郭道遐, 陈燕春, 王林红, 鲁玮, 沈冲, 杨松, 赵祥海, 金岳龙, 姚应水. 高迁移率族蛋白1基因多态性与中国南方农村常用高血压药物疗效的关系[J]. 中国临床药理学与治疗学, 2014, 19(7): 766-771.
[5]	江延姣, 叶慧君, 刘佳俐, 赵再秋, 孙凯. 重楼生化汤对剖宫产术后子宫内膜MMP-9及其抑制物TIMP-1表达及血白细胞、C-反应蛋白的影响[J]. 中国临床药理学与治疗学, 2014, 19(5): 542-547.
[6]	尹芳, 李云飞, 黄继汉, 李禄金, 郑青山. 长效降压药动态血压试验设计与定量分析方法实例介绍[J]. 中国临床药理学与治疗学, 2012, 17(6): 666-671.
[7]	金岳龙, 贺连平, 陈金凤, 王彬彬, 沈冲, 姚应水. C-反应蛋白基因多态性与代谢综合征的关联研究[J]. 中国临床药理学与治疗学, 2011, 16(12): 1391-1396.
[8]	徐承华, 杨玉雯, 曹蘅. β₁肾上腺素受体与CYP2D6基因多态性对美托洛尔抗高血压治疗的影响[J]. 中国临床药理学与治疗学, 2011, 16(12): 1414-1418.
[9]	张龙, 盛蕾, 陈金凤, 杨松, 沈冲. 超敏C-反应蛋白与高血压关系的病例对照研究[J]. 中国临床药理学与治疗学, 2011, 16(10): 1164-1168.
[10]	彭翠英, 周翠兰, 贺庆芝. 湖南汉族人群TNF-α基因-308G/A多态与原发性高血压相关性研究[J]. 中国临床药理学与治疗学, 2011, 16(1): 57-60.
[11]	史海霞, 黄继汉, 李庆海, 卞卡. 祛瘀宁心丸治疗不稳定型心绞痛的疗效及其血清C-反应蛋白的影响[J]. 中国临床药理学与治疗学, 2009, 14(5): 582-585.
[12]	唐强, 黄友良, 俞群军, 黄琼, 尹继业, 周宏灏, 刘昭前. 血管紧张素转化酶基因多态性与依那普利降压疗效的相关性研究[J]. 中国临床药理学与治疗学, 2009, 14(1): 72-75.
[13]	沈丹丹, 卞智萍, 何国平, 顾春荣, 徐晋, 杨笛, 张寄南. 定量检测人超敏C-反应蛋白双抗体夹心ELISA 方法的建立及初步临床应用[J]. 中国临床药理学与治疗学, 2009, 14(1): 84-89.
[14]	徐海红, 杨利才, 杨沿浪, 张道友. 缬沙坦降低慢性肾衰竭大鼠心肌内皮素的表达[J]. 中国临床药理学与治疗学, 2008, 13(6): 639-643.
[15]	黄海英, 周宏灏. G蛋白β3亚基C825T多态性与原发性高血压[J]. 中国临床药理学与治疗学, 2008, 13(3): 355-360.