發(fā)布時(shí)間：2018-05-13 06:29

  本文選題：兒茶酚抑素 + 嗜鉻粒蛋白A��； 參考：《皖南醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討血漿中人兒茶酚抑素(catestatin,CST)、嗜鉻粒蛋白A(Chromogranin,CGA)水平與原發(fā)性高血壓之間關(guān)聯(lián),及CST、CGA與原發(fā)性高血壓患者左心室肥厚之間的關(guān)系。方法:選取71例原發(fā)性高血壓患者(排除心力衰竭),男28例,女43例,平均年齡66.77±11.43歲。按照中國(guó)高血壓防治指南血壓水平分為高血壓1級(jí),高血壓2級(jí),高血壓3級(jí)3組,另單獨(dú)選取同期健康體檢者30例,其中男15例,女15例,平均年齡62.23±8.51歲。原發(fā)性高血壓患者登記既往血壓最高值,健康者取體檢時(shí)測(cè)定血壓值,并測(cè)量所有受試者身高、體重、血常規(guī)、血生化、腦鈉肽(Brain Natriuretic Peptide,BNP)等一般資料,同時(shí)測(cè)定空腹外周血中CST及CGA水平。并完善心超、心電圖、胸片等相關(guān)檢查。根據(jù)心超所測(cè)左室射血分?jǐn)?shù)(LVEF)、舒張末期左室腔內(nèi)徑(LVIDd)、舒張末期室間隔厚度(interventricular septum thickness,IVST)、舒張末期左室后壁厚度(Left Ventricular Posterior Wall Thickness,LVPWT)等相關(guān)數(shù)據(jù),求取左心室質(zhì)量指數(shù)(LVMI),并采用脈沖多普勒分別測(cè)量二尖瓣舒張?jiān)缙谘鞣逯邓俣?E峰),舒張晚期血流峰值速度(A峰),計(jì)算E/A值,分為E/A1及E/A1,應(yīng)用spss19.0軟件比較各組指標(biāo)之間是否存在統(tǒng)計(jì)學(xué)差異。再將高血壓組患者根據(jù)LVMI分為左室肥厚組和非左室肥厚組,統(tǒng)計(jì)分析各組間CST、CGA、LVMI等指標(biāo)的差異。2結(jié)果:1.原發(fā)性高血壓組外周血中CST水平較健康對(duì)照組水平明顯降低(P0.05)。高血壓并左心室肥厚組CST水平也明顯低于高血壓非左心室肥厚組及健康對(duì)照組。原發(fā)性高血壓組外周血中CGA水平較健康組升高(P0.05),且在高血壓并左心肥厚組也明顯高于其他兩組水平(P0.05)。2.線性相關(guān)分析結(jié)果示:外周血CST水平與SBP(r=-0.696,P0.05)、LVMI(r=-0.472,P0.05)呈負(fù)相關(guān)。CGA水平與SBP(r=0.483,P0.05)、LVMI(r=0.349,P0.05)呈正相關(guān)。外周血中CGA與CST濃度呈負(fù)相關(guān)(r=-0.681,P0.05)3.與健康組對(duì)比高血壓組舒張功能明顯受損,E/A值具有顯著差異(P0.05),高血壓組E/A1例數(shù)明顯高于健康組。且隨著患者血壓水平升高,患者靶器官損害程度越重,高血壓組LVMI較健康對(duì)照組明顯增高(P0.05),但4組射血分?jǐn)?shù)LVEF無(wú)明顯差異(P0.05)。結(jié)論:1.原發(fā)性高血壓患者外周血中兒茶酚抑素(CST)水平較健康者明顯降低,且與血壓增高水平呈負(fù)相關(guān)。2.原發(fā)性高血壓患者外周血中嗜鉻粒蛋白A(CGA)水平較健康者增高,與收縮壓成正比。3.原發(fā)性高血壓患者外周血中CGA、CST水平可反映靶器官左心室肥厚的嚴(yán)重程度,但尚不能作為預(yù)測(cè)左心室肥厚的獨(dú)立危險(xiǎn)因子。
[Abstract]:Aim: to investigate the relationship between plasma levels of human catechol-statin (CSTN), Chromogranin (CGA) and essential hypertension (EH), and between CST-CGA and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH). Methods: 71 patients with essential hypertension (male 28, female 43, mean age 66.77 鹵11.43 years) were selected. According to the Chinese hypertension prevention and treatment guidelines, blood pressure was divided into 3 groups: hypertension grade 1, hypertension grade 2, hypertension grade 3, and 30 healthy persons were selected separately, including 15 males and 15 females, with an average age of 62.23 鹵8.51 years. The highest value of blood pressure was registered in patients with essential hypertension, and the blood pressure was measured at the time of physical examination. The general data of height, weight, blood routine, blood biochemistry, brain natriuretic peptide (Brain Natriuretic Peptideus) and so on were measured. At the same time, the levels of CST and CGA in fasting peripheral blood were measured. And improve cardiac ultrasound, electrocardiogram, chest radiographs and other related examinations. According to the data of left ventricular ejection fraction (LVEF), left ventricular cavity diameter (LVIDdT), interventricular septum thickness-IVSTT, left ventricular posterior wall thickness (eft) and left ventricular posterior wall thickness (left ventricular posterior wall thickness) measured by echocardiography, left ventricular cavity diameter (LVIDdT) at the end of diastolic period, and interventricular septum thickness, etc. The left ventricular mass index (LVMIA) was obtained, and the peak velocity of mitral early diastolic and late diastolic peak velocities were measured by pulse Doppler, and the E / A value was calculated. Divided into E/A1 and E / A 1, spss19.0 software was used to compare whether there were statistical differences between each group. The patients in hypertension group were divided into left ventricular hypertrophy group and non-left ventricular hypertrophy group according to LVMI. The level of CST in peripheral blood of essential hypertension group was significantly lower than that of healthy control group. The level of CST in hypertension with left ventricular hypertrophy group was significantly lower than that in hypertension non-left ventricular hypertrophy group and healthy control group. The level of CGA in peripheral blood of essential hypertension group was higher than that of healthy group, and the level of CGA in hypertension with left ventricular hypertrophy group was significantly higher than that in other two groups. The results of linear correlation analysis showed that there was a negative correlation between the level of CST in peripheral blood and LVMIR r-0.472P 0.05 (P 0.05). There was a positive correlation between the level of CST and the level of CST. There was a negative correlation between CGA and CST in peripheral blood. Compared with the healthy group, the diastolic function in the hypertension group was significantly impaired and the E / A value was significantly different (P 0.05). The number of E/A1 in the hypertension group was significantly higher than that in the healthy group. With the increase of blood pressure, the degree of target organ damage was more serious, LVMI in hypertension group was significantly higher than that in healthy control group (P 0.05), but no significant difference in ejection fraction (LVEF) was found among the four groups. Conclusion 1. The levels of catechol-statin (CSTs) in peripheral blood of patients with essential hypertension were significantly lower than those of healthy subjects, and were negatively correlated with the increase of blood pressure. The level of chromogranin A CGA in peripheral blood of patients with essential hypertension was higher than that of healthy subjects, which was directly proportional to systolic blood pressure (SBP). The level of CGAN CST in peripheral blood of patients with essential hypertension can reflect the severity of left ventricular hypertrophy in target organs, but it can not be used as an independent risk factor for predicting left ventricular hypertrophy.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R544.11

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