J4 ›› 2011, Vol. 37 ›› Issue (5): 909-914.

• 基础研究 • 上一篇    下一篇

血管紧张素转换酶2与原发性高血压及心功能的关系

李晶|曹鸿雁|秦玲   

  1. 吉林大学第一医院二部心内科|吉林 长春 130021
  • 收稿日期:2011-05-27 出版日期:2011-09-28 发布日期:2011-09-28
  • 通讯作者: 秦 玲(Tel: 0431-84808229,E-mail:qinling@medmail.com.cn) E-mail:qinling@medmail.com.cn
  • 作者简介:李 晶(1985-)|女|黑龙江省齐齐哈尔市人|在读医学硕士|主要从事高血压疾病的基础和临床研究。
  • 基金资助:

    吉林省科技厅科研基金资助课题(200905138)

Relationships between angiotensin-converting enzyme 2 and essential hypertension and heart function

LI Jing,CAO Hong-yan,QIN Ling   

  1. Department of Cardiology,First Hospital,Jilin Univesity,Changchun 130021,China
  • Received:2011-05-27 Online:2011-09-28 Published:2011-09-28

摘要:

目的:探讨血管紧张素转换酶2(ACE2)与原发性高血压及心功能的关系,阐明其在高血压发生、发展中的作用。方法:选择原发性高血压患者113例作为试验组(EH组),其中无左室收缩功能减退组(非HF组)65例,高血压并发左室收缩功能减退组(HF组)48例,正常对照组60例。采用酶联免疫吸附(ELISA)法检测113例原发性高血压患者及60例正常对照者血清中ACE2、血管紧张素Ⅱ(AngⅡ)、心钠肽(ANP)和脑钠肽(BNP)的水平;采用χ2检验、两独立样本t检验、方差分析和逐步回归分析等方法对检测指标和临床资料进行统计学分析。结果:与对照组比较,高血压患者无左室收缩功能减退时血清ACE2水平明显减低(P<0.05),AngⅡ、ANP和BNP水平明显增高(P<0.05);当高血压伴有心力衰竭时,ACE2、AngⅡ、ANP和BNP水平均明显高于无心力衰竭者(P<0.05);多元逐步回归分析,ACE2、AngⅡ、ANP和BNP与高血压病程、左室舒末径呈正相关关系(r=0.034,r=8.466,r=1.300,r=2.004,P<0.01;r=0.265,r=5.019,r=4.303,r=2.099,P<0.01),与射血分数(EF)呈负相关关系(r=-0.815,r=-4.077,r=-10.137,r=-13.116,P<0.01)。结论:在高血压和心力衰竭的发生过程中,肾素-血管紧张素系统(RAS)的激活和心室的扩张造成了AngⅡ、ANP及BNP的释放增加。ACE2作为新的心血管保护因子,在高血压的发生发展以及心力衰竭的发生过程中释放增加,拮抗AngⅡ过度释放造成的心血管损伤,发挥心血管保护作用。

关键词: 高血压;血管紧张素转换酶2;血管紧张素Ⅱ;心钠肽;脑钠肽

Abstract:

bstract:Objective To investigate the relationships between angiotensin-converting enzyme 2(ACE2) and essential hypertension (EH) and heart function,and to clarify the function of ACE2 in the development of hypertension. Methods 113 EH patients were selected as  experiment group(EH group),there were two parts in  EH group: the group of patients who had non-left ventricular systolic dysfunction (non-HF group,65 cases),and the group of patients who had  left ventricular systolic dysfunction (HF group,48 cases).60 cases of healthy people were selected as control group.The levels of ACE2,angiotensin Ⅱ(Ang Ⅱ),atrial natriuretic peptide(ANP) and brain natruretic peptide(BNP) in the serum of 113 EH patients and 60 normal persons were detected by ELISA method. And the Chisquare test,independent-samples t test,ANOVA and stepwise regression analysis were used to analyze those clinic results. Results The levels of ACE2 in non-HF group was significantly lower than those in control group (P<0.05),and the levels of AngⅡ,ANP and BNP were significantly higher than that in control group (P<0.05). In addition,when EH came along with heart failure,the levels of ACE2,AngⅡ,ANP and BNP in HF group were statistically higher than those in non-HF group. The multiple stepwise regression analysis showed that the evels of ACE2,AngⅡ,ANP and BNP were positively correlated with the courses of hypertension and the left ventricular end-diastolic diameter(LVDD)(r=0.034,r=8.466,r=1.300,r=2.004,P<0.01;r=0.265,r=5.019,r=4.303,r=2.099,P<0.01);and negatively correlated with the ejection fraction(EF)(r=-0.815,r=-4.077,r=-10.137,r=-13.116,P<0.01). Conclusion During the occurrence of hypertension and heart failure,the activation of renin-angiotensin system(RAS)  together with the expansion of ventricle lead to the rise of the release of AngⅡ,ANP and BNP. As a novel cardiovascular protective factor,the level of release of ACE2 increases in the process of hypertension and heart failure,and counteracts the cardiovascular damage caused by the excessive release of AngⅡ,thus protecting the cardiac vessel.

Key words: hypertension;angiotensin-converting enzyme 2;angiotensinⅡ;atrial natriuretic peptide;brain natriuretic peptide

中图分类号: 

  • R543