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目的:观察和分析高龄老年患者原发性高血压(EH)分期和不同控制状态与血浆血管活性物质及血脂水平的关系。方法:80岁以上离退休人员60例为研究对象,分为Ⅰ,Ⅱ,Ⅲ期,血压控制理想组与不理想组。应用放射免疫法测定血浆肾上腺髓质素(ADM)、内皮素(ET)、心房钠尿肽(ANP)和血管紧张素Ⅱ(AngⅡ)的水平,硝酸还原酶法测定NO。血脂采用酶试剂法,免疫浊度法。结果:EHⅠ期AngⅡ显著升高,EHⅡ期ADM,ET,ANP显著升高,NO显著降低。EHⅢ期ADM,ET,ANP,AngⅡ较Ⅱ期显著升高,NO较Ⅰ,Ⅱ期显著降低。理想组NO,ANP,AngⅡ较对照组无显著差异,理想组较不理想组ADM,NO,ET,ANP有显著差异。血脂指标在各组间无显著差异。结论:血管活性物质的水平可作为临床分期与评价治疗效果的指标之一。
OBJECTIVE: To observe and analyze the relationship between essential hypertension (EH) staging and different control states and plasma vasoactive substances and blood lipid levels in the elderly elderly patients. Methods: Sixty retired people over the age of 80 were selected as study objects and divided into Ⅰ, Ⅱ and Ⅲ stages, ideal and non-ideal group of blood pressure control. The levels of plasma adrenomedullin (ADM), endothelin (ET), atrial natriuretic peptide (ANP) and angiotensin Ⅱ (Ang Ⅱ) were measured by radioimmunoassay. NO was measured by nitrate reductase method. Blood lipids using enzyme reagent, immune turbidimetry. Results: The level of AngⅡ in EH Ⅰ phase was significantly increased. The levels of ADM, ET and ANP in EH Ⅱ phase were significantly increased while NO was significantly decreased. The levels of ADM, ET, ANP and AngⅡ in stage EH were significantly higher than those in stage Ⅱ, and the levels of NO were significantly lower than those in stage Ⅰ and Ⅱ. NO, ANP and AngⅡ in the ideal group were not significantly different from those in the control group, and ADM, NO, ET and ANP in the ideal group were significantly different from those in the ideal group. There was no significant difference between the two groups in blood lipids. Conclusion: The level of vasoactive substances can be used as a clinical stage and evaluation of the therapeutic effect of one of the indicators.