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目的探讨气体信号分子硫化氢(H2S)及一氧化氮(NO)在高原高血压的病理生理意义。方法平原体检正常者进入海拔5000m高原(1~3)月期间,在高原暴露时间、劳动强度及生活条件相同的施工群体中随机抽样127人。依血压变化将其分为高原高血压(Ⅰ~Ⅲ级)组78人(进一步分为收缩期高原高血压组与舒张期高原高血压组),高原正常血压组49人,采取肘静脉血,采用敏感硫电极法测定其H2S浓度,Griess法测定血清NO含量。结果高原高血压组、收缩期高原高血压组、舒张期高原高血压组的血清H2S与NO平均含量均显著增加,分别比正常血压组高34·5%,36·9%,31·7%(均P<0·001)与28·4%,33·1%,39·7%,(均P<0·05),尤以H2S更为突出;随着血压分级程度的升高H2S与NO血清含量相应增高,也以H2S更显著(R2=0·918);H2S与NO、舒张压间均有密切正相关关系及良好的拟和优度、与氧饱和度呈显著的负相关与拟和优度(R2=0·374,P=0·001)。结论H2S与NO的代谢失常可能参与了高原高血压发病过程。
Objective To investigate the pathophysiological significance of gas signaling molecules hydrogen sulfide (H2S) and nitric oxide (NO) in plateau hypertension. Methods A total of 127 normal people were enrolled in the construction community with the same exposure time, labor intensity and living conditions during the altitude of 5000m plateau (1-3 months). According to the change of blood pressure, it was divided into high altitude (grade Ⅰ ~ Ⅲ) group of 78 people (further divided into systolic hypertension group and diastolic high altitude hypertension group), plateau normal blood pressure group of 49 people, Sensitized sulfur electrode method was used to determine the concentration of H2S, and Griess method was used to determine the content of serum NO. Results The mean levels of serum H2S and NO in plateau hypertensive group, systolic plateau hypertensive group and diastolic plateau hypertensive group increased significantly, which were 34.5%, 36.9% and 31.7% higher than those in normal blood pressure group respectively (All P <0.001) and 28.4%, 33.1% and 39.7% respectively (all P <0.05), especially H2S. With the increase of blood pressure classification, H2S and The serum level of NO increased accordingly (R2 = 0. 918). There was a close positive correlation between H2S and NO and diastolic blood pressure and a good goodness of fit, which was negatively correlated with oxygen saturation Quasi goodness of fit (R2 = 0.374, P = 0.001). Conclusions The metabolic disorders of H2S and NO may be involved in the pathogenesis of high altitude hypertension.