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目的研究原发性高血压患者血浆肾上腺髓质素(ADM)、降钙素基因相关肽(CGRP)的水平变化,探讨两种血管活性物质在原发性高血压危险性分层中的变化及临床意义。方法随机选择80例原发性高血压患者和20例正常人作对照,根据《1999年 WHO/ISH 高血压诊疗指南》中的危险分层标准将原发性高血压病人分为低危、中危、高危和极高危等4组。用放射免疫法测定血浆 ADM、CGRP 的含量。结果血浆 ADM 的浓度在低危组、中危组、高危组和极高危组及正常对照组分别为36.28±10.12、41.28±8.09、66.64±10.22、87.90±10.39和15.26±4.30ng/L,低危组、中危组、高危组和极高危组与正常对照组比较有显著性差异(P<0.01),且随危险分层的增高而逐渐显著增高。血浆 CGRP 的浓度在低危组、中危组、高危组和极高危组及正常对照组分别为59.48±9.42、55.92±10.01、47.36±8.87、37.61±9.61和71.08±6.43ng/L,低危组、中危组、高危组和极高危组与正常对照组比较有显著性差异(P<0.01)。且随危险分层的增高而逐渐显著降低。血浆 ADM 与 CGRP 呈负相关(r=-0.742,P<0.01)。结论血浆肾上腺髓质素、降钙素基因相关肽参与了原发性高血压的病理生理过程及靶器官损害,可以反映原发性高血压的危险性分层。
Objective To study the changes of plasma adrenomedullin (ADM) and calcitonin gene related peptide (CGRP) levels in patients with essential hypertension and to explore the changes of the two vascular active substances in the risk stratification of essential hypertension. Clinical significance. Methods A total of 80 patients with essential hypertension and 20 normal controls were selected randomly. According to the criteria of risk stratification in WHO Guideline for Diagnosis and Treatment of Hypertension 1999 WHO, patients with essential hypertension were divided into low-risk Dangerous, high-risk and very high risk group 4. The levels of ADM and CGRP in plasma were determined by radioimmunoassay. Results The plasma concentrations of ADM were 36.28 ± 10.12, 41.28 ± 8.09, 66.64 ± 10.22, 87.90 ± 10.39 and 15.26 ± 4.30 ng / L in low risk group, moderate risk group, high risk group and very high risk group, respectively There were significant differences between the high risk group and the high risk group and the normal control group (P <0.01), and gradually increased with the increase of risk stratification. The levels of plasma CGRP were 59.48 ± 9.42,55.92 ± 10.01,47.36 ± 8.87,37.61 ± 9.61 and 71.08 ± 6.43ng / L in low-risk group, moderate-risk group, high-risk group, and very high-risk group, respectively There were significant differences between the high risk group and the high risk group and the normal control group (P <0.01). And with the risk stratification increased and gradually decreased significantly. There was a negative correlation between plasma ADM and CGRP (r = -0.742, P <0.01). Conclusions Plasma adrenomedullin and calcitonin gene-related peptide are involved in the pathophysiological process and target organ damage of essential hypertension, which can reflect the risk stratification of essential hypertension.