H型高血压患者心肌纤维化与血管紧张素Ⅱ、膜型基质金属蛋白酶1水平变化的相关性
摘要
目的探讨H型高血压患者心肌纤维化(MF)与血清血管紧张素(Ang)Ⅱ、膜型基质金属蛋白酶1(MT1-MMP)水平变化的相关性。方法共纳入研究者187例,根据血压及同型半胱氨酸(Hcy)水平将患者分为H型高血压组72例、高血压对照组55例、正常对照组60例。收集一般临床资料和血生化检查结果,采用磁共振成像技术进行MF检测及图像分析测量T1值;采用酶联免疫法测定血清Hcy,MT1-MMP水平;采用放射免疫法检测血清AngⅡ水平,并且分析比较各组患者的T1值及T1值与血清Hcy、AngⅡ、MT1-MMP水平的相关性。结果 H型高血压组、高血压对照组、正常对照组T1值、血清AngⅡ、MT1-MMP水平比较差异有统计学意义(P<0. 05)。直线相关分析T1值与血清Hcy、AngⅡ、MT1-MMP水平均呈负相关(P<0. 05)。血清Hcy与AngⅡ、MT1-MMP水平呈正相关(P<0. 05)。结论高血压、Hcy是MF的危险因素。高血压、Hcy可能通过AngⅡ、MT1-MMP诱导H型高血压患者MF的发生。
引文
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25 Goldsmith EC,Bradshaw AD,Spinale FG.Cellular mechanisms of tissue fibrosis.2.Contributory pathways leading to myocardial fibrosis:moving beyond collagen expression[J].Am J Physiol Cell Physiol,2013;304(5):C393-402.
2刘力生.中国高血压防治指南[J].中华高血压杂志,2011;19(8):741-3.
3 Passino C,Barison A,Vergaro G,et al.Markers of fibrosis,inflammation,and remodeling pathways in heart failure[J].Clin Chim Acta,2015;443:29-38.
4 Cohen E,Levi A,Vecht-Lifshitz SE,et al.Assessment of a possible link between hyperhomocysteinemia and hyperuricemia[J].J Investig Med,2015;63(3):534-8.
5李建平,卢新政,霍勇,等.H型高血压诊断与治疗专家共识[J].中华高血压杂志,2016;24(2):123-7.
6 Li L,Zhang ZC,Lei H,et al.AngiotensinⅡreduces cardiac adipo R1expression through AT1 receptor/ROS/ERK1/2/c-Myc pathway[J].PLoS One,2013;8(1):e49915.
7 Spinale FG,Janicki JS,Zile MR.Membrane-associated matrix proteolysis and heart failure[J].Circ Res,2013;112(1):195-208.
8温霞,何涛,贺文帅,等.急诊治疗126例重症心力衰竭的临床效果探究[J].现代诊断与治疗,2014;25(24):5523-6.
9 Touvron M,Escoubet B,Mericskay M,et al.Locally expressed IGF1propeptide improves mouse heart function in induced dilated cardiomyopathy by blocking myocardial fibrosis and SRF-dependent CTGFinduction.[J].Dis Mod Mechan,2012;5(4):481-91.
10 Kong P,Christia P,Frangogiannis NG.The pathogenesis of cardiac fibrosis[J].Cell Mol Life Sci,2014;71(4):549-74.
11 Czubryt MP.Common threads in cardiac fibrosis,infarct scar formation,and wound healing[J].Fibroge Tissue Repair,2012;5(1):19.
12 Durand P,Prost M,Loreau N,et al.Impaired homocysteine metablolism and atherothrombotic disease[J].Lab Invest,2001;81(5):645-72.
13 Roy SJ.Protective effects of sinapic acid on cardiac hypertrophy,dyslipidaemia and altered electrocardiogram in isoproterenol-induced myocardial infarcted rats[J].Eur J Pharmacol,2013;699(13):213-8.
14 Silambarasan T,Manivannan J,Krishna Priya M,et al.Sinapic acid prevents hypertension and cardiovascular remodeling in pharmacological model of nitric oxide inhibited rats[J].PLoS One,2014;9(12):e115682.
15 Zhang Y,Shao L,Ma A,et al.Telmisartan delays myocardial fibrosis in rats with hypertensive left ventricular hypertrophy by TGF-b1/Smad signal pathway[J].Hypertens Res,2014;37(1):43-9.
16 Ankrah A,Buscombe J,Sathekge MM.Association between plasma homocysteine and myocardial SPECT abnormalities in patients referred for suspected myocardial ischaemia[J].Cardiovasc J Afr,2012;23(6):313-7.
17 Nasso G,Bonifazi R,Romano V,et al.Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasiveepicardial ablation for nonvalvular atrial fibrillation[J].J Thorac Cardiovasc Surg,2013;146(4):848-53.
18 Kong P,Christia P,Frangogiannis NG.The pathogenesis of cardiac fibrosis[J].Cell Mol Life Sci,2014;71(4):549-74.
19 Siddesha JM,Valente AJ,Sakamuri SS,et al.AngiotensinⅡstimulates cardiac fibroblast migration via the differential regulation of matrixins and RECK[J].J Mol Cell Cardiovasc,2013;65(1):8-9.
20 Billet S,Aguilar F,Baudry C,et al.Role of angiotensinⅡAT1 receptor activation in cardiovascular diseases[J].Kidney Int,2008;74(11):1379-84.
21 Yuan SM,Jing H.Cardiac pathologies in relation to Smad-dependent pathways[J].Interact Cardiovasc Thorac Surg,2010;11(4):455-60.
22 Diaklov SI,Nazarevicz RR,Bikineyeva A,et al.Nox2-induced production of mitochondrial superoxide in angiotensinⅡ-mediated endothelial oxidative stress and hypertension[J].Antioxid Redox Signal,2014;20(2):281-94.
23 Essa EM,Zile MR,Stroud RE,et al.Changes in plasma profiles of matrix metalloproteinases(MMPs)and tissue inhibitors of MMPs in stress-induced cardiomyopathy[J].J Card Fail,2012;18(6):487-92.
24 Itoh Y,Seiki M.MT1-MMP:an enzyme with multidimensional regulation[J].Trends Biochem Sci,2004;29(6):285-9.
25 Goldsmith EC,Bradshaw AD,Spinale FG.Cellular mechanisms of tissue fibrosis.2.Contributory pathways leading to myocardial fibrosis:moving beyond collagen expression[J].Am J Physiol Cell Physiol,2013;304(5):C393-402.