青中年正常高值血压伴高胆固醇血症患者血浆big ET-1水平及综合干预对其的影响
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摘要
目的探讨综合干预对青中年正常高值血压伴高胆固醇血症患者血浆大内皮素-1(big endothelin-1,big ET-1)水平的影响,并探讨其临床意义。方法选择浙江医院2012年10月—2014年12月符合标准的青中年正常血压者200例作为对照组,青中年正常高值血压伴高胆固醇血症患者200例作为观察组。观察组患者给予综合干预。采用全自动生化分析仪测定患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)水平;采用酶联免疫吸附测定(ELISA)法测定血浆big ET-1水平。结果观察组患者收缩压、舒张压及TC、TG、LDL-C、big ET-1水平高于对照组(均P<0.05)。综合干预后各时间点收缩压、舒张压、TC、TG、LDL-C、big ET-1水平均低于干预前(均P<0.05);随着干预时间延长,收缩压、舒张压、TC、TG、LDL-C、big ET-1水平不断降低,各时间点之间比较差异均有统计学意义(P<0.05)。收缩压、TC、HDL-C为血浆big ET-1水平的影响因素(均P<0.05)。结论青中年正常高值血压伴高胆固醇血症患者血浆big ET-1水平明显升高,综合干预可降低患者血浆big ET-1水平,对预防内皮功能损伤具有重要意义。
Objective To explore the effect of comprehensive intervention on plasma big ET-1 Level in normal middleaged patients of normal high blood pressure with hypercholesterolemia.Methods Two hundred patients with normal blood pressure were selected as the control group,and 200 patients with normal high blood pressure were selected as the observation group from October 2012 to December 2014 in Zhejiang Hospital.Patients in the observation group were given comprehensive intervention.The levels of triglycerides(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C) level were measured by automatic biochemical analyzer.The level of plasma big ET-1was determined by enzyme-linked immunosorbent assay(ELISA).Results The systolic and diastolic blood pressure and the levels of TC,TG,LDL-C,big ET-1 in the observation group were higher than those in the control group(all P <0.05).After intervention,the systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C,and big ET-1 levels at various time points were lower than those before intervention(all P < 0.05).With the prolongation of the intervention time,the systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C and big ET-1 levels continued to decrease,and there were statistically significant differences among the time points(all P < 0.05).Systolic blood pressure,TC and HDL-C were the influencing factors of plasma big ET-1(all P < 0.05).Conclusion The level of plasma big ET-1 in patients with normal high blood pressure with hypercholesterolemia is significantly higher.Comprehensive intervention can reduce the plasma ET-1 levels of the patients,and has great significance on the prevention of endothelial dysfunction.
Objective To explore the effect of comprehensive intervention on plasma big ET-1 Level in normal middleaged patients of normal high blood pressure with hypercholesterolemia.Methods Two hundred patients with normal blood pressure were selected as the control group,and 200 patients with normal high blood pressure were selected as the observation group from October 2012 to December 2014 in Zhejiang Hospital.Patients in the observation group were given comprehensive intervention.The levels of triglycerides(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C) level were measured by automatic biochemical analyzer.The level of plasma big ET-1was determined by enzyme-linked immunosorbent assay(ELISA).Results The systolic and diastolic blood pressure and the levels of TC,TG,LDL-C,big ET-1 in the observation group were higher than those in the control group(all P <0.05).After intervention,the systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C,and big ET-1 levels at various time points were lower than those before intervention(all P < 0.05).With the prolongation of the intervention time,the systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C and big ET-1 levels continued to decrease,and there were statistically significant differences among the time points(all P < 0.05).Systolic blood pressure,TC and HDL-C were the influencing factors of plasma big ET-1(all P < 0.05).Conclusion The level of plasma big ET-1 in patients with normal high blood pressure with hypercholesterolemia is significantly higher.Comprehensive intervention can reduce the plasma ET-1 levels of the patients,and has great significance on the prevention of endothelial dysfunction.
引文
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[16]赵晓芳,鹿育萨,刘星,等.正常高值血压伴不同尿酸水平人群血浆大内皮素-1水平观察[J].中西医结合心脑血管病杂志,2015,13(2):236-238.
[17]LATUS H,KARANATSIOS G,BASAN U,et al.Clinical and prognostic value of endothelin-1 and big endothelin-1 expression in children with pulmonary hypertension[J].Heart,2016,102(13):1052-1058.
[18]叶棣荣,李木轩,谢润平.正常高值血压人群的生活方式干预效果研究[J].实用心脑肺血管病杂志,2014,22(6):40-41.
[19]沈艳芳,雷玉华,黄浩.青年正常高值血压人群生活方式干预效果评价[J].中国循证心血管医学杂志,2013,5(1):27-28.
[20]YANG Z X,WANG Y Z,JIA B B,et al.Downregulation of miR-146a,cyclooxygenase-2 and advanced glycation end-products in simvastatin-treated older patients with hyperlipidemia[J].Geriatr Gerontol Int,2016,16(3):322-328.
[2]KOUGUCHI T,OHMORI T,SHIMIZU M,et al.Effects of a chicken collagen hydrolysate on the circulation system in subjects with mild hypertension or high-normal blood pressure[J].Biosci Biotechnol Biochem,2013,77(4):691-696.
[3]CHEN J,CHEN M H,GUO Y L,et al.Plasma big endothelin-1 level and the severity of new-onset stable coronary artery disease[J].J Atheroscler Thromb,2015,22(2):126-135.
[4]刘星,鹿育萨,赵晓芳,等.正常高值血压合并高胆固醇血症患者血浆大内皮素-1水平观察[J].中西医结合心脑血管病杂志,2014,12(11):1328-1329.
[5]高雅莉,贡时雨,王晨,等.生活方式干预对正常高值血压及轻度高血压患者血压水平的影响[J].中国卫生产业,2015,12(11):29-30.
[6]童程程,唐海沁,李瑾.依折麦布联合辛伐他汀降脂疗效和安全性的Meta分析[J].中国循证心血管医学杂志,2013,5(2):116-120.
[7]MORRIS R,SPENCER S K,KYLE P B,et al.Hypertension in an animal model of HELLP syndrome is associated with activation of endothelin 1[J].Reprod Sci,2016,23(1):42-50.
[8]吴泽兵,张颖,余其贵,等.贝那普利与氨氯地平联合口服对老年高血压患者血压变异性及血浆一氧化氮、内皮素水平的影响[J].山东医药,2016,56(11):46-48.
[9]张欢欢,韩冰,廉银珠,等.不同水平高血压患者血清Klotho蛋白、NO、ET-1的表达水平及相关性[J].中国老年学杂志,2015,35(3):596-599.
[10]ZHU L A,FANG N Y,GAO P J,et al.Differential ERK1/2 signaling and hypertrophic response to endothelin-1 in cardiomyocytes from SHR and wistar-kyoto rats:A potential target for combination therapy of hypertension[J].Curr Vasc Pharmacol,2015,13(4):467-474.
[11]LANKHORST S,KAPPERS M H,VAN ESCH J H,et al.Hypertension during vascular endothelial growth factor inhibition:focus on nitric oxide,endothelin-1,and oxidative stress[J].Antioxid Redox Signal,2014,20(1):135-145.
[12]CAMPIA U,MATUSKEY L A,TESAURO M,et al.PPARγactivation does not affect endothelin activity in non-diabetic patients with hypertension or hypercholesterolemia[J].Atherosclerosis,2014,234(2):436-440.
[13]SOROP O,VAN DEN HEUVEL M,VAN DITZHUIJZEN N S,et al.Coronary microvascular dysfunction after long-term diabetes and hypercholesterolemia[J].Am J Physiol Heart Circ Physiol,2016,311(6):H1339-H1351.
[14]FUKUMOTO S,HANAZONO K,MIYASHO T,et al.Serum big endothelin-1 as a clinical marker for cardiopulmonary and neoplastic diseases in dogs[J].Life Sci,2014,118(2):329-332.
[15]ZHENG L H,SUN W,YAO Y,et al.Associations of big endothelin-1and C-reactive protein in atrial fibrillation[J].J Geriatr Cardiol,2016,13(5):465-470.
[16]赵晓芳,鹿育萨,刘星,等.正常高值血压伴不同尿酸水平人群血浆大内皮素-1水平观察[J].中西医结合心脑血管病杂志,2015,13(2):236-238.
[17]LATUS H,KARANATSIOS G,BASAN U,et al.Clinical and prognostic value of endothelin-1 and big endothelin-1 expression in children with pulmonary hypertension[J].Heart,2016,102(13):1052-1058.
[18]叶棣荣,李木轩,谢润平.正常高值血压人群的生活方式干预效果研究[J].实用心脑肺血管病杂志,2014,22(6):40-41.
[19]沈艳芳,雷玉华,黄浩.青年正常高值血压人群生活方式干预效果评价[J].中国循证心血管医学杂志,2013,5(1):27-28.
[20]YANG Z X,WANG Y Z,JIA B B,et al.Downregulation of miR-146a,cyclooxygenase-2 and advanced glycation end-products in simvastatin-treated older patients with hyperlipidemia[J].Geriatr Gerontol Int,2016,16(3):322-328.