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目的:探讨血管紧张素Ⅱ(ATⅡ)、干扰素γ(IFN-γ)、白细胞介素(IL)-4及IL-17水平与原发性高血压患者早期肾损害的关系。方法:68例原发性高血压患者依据尿白蛋白排泄率检测结果分为早期肾损害组和无肾损害组,健康体检者24例作为对照组。采用放射免疫法检测血浆ATⅡ水平,ELISA法检测血清中IFN-γ、IL-4和IL-17水平。结果:早期肾损害组ATⅡ、IFN-γ和IL-17水平增高,与无肾损害组和对照组相比差异有统计学意义;3组IL-4水平变化小,差异无统计学意义;ATⅡ水平与IFN-γ、IL-17水平呈正相关,而与IL-4水平无相关性。结论:原发性高血压患者的高ATⅡ水平使效应性T淋巴细胞亚群活性发生变化,导致Th1、Th17的功能上调与早期肾损害的发生和发展。
Objective: To investigate the relationship between the levels of angiotensin Ⅱ (ATⅡ), interferon γ (IFN-γ), interleukin (IL) -4 and IL-17 in patients with essential hypertension and early renal damage. Methods: Sixty-eight patients with essential hypertension were divided into early renal impairment group and non-renal impairment group according to urinary albumin excretion rate test. 24 healthy subjects were used as control group. Plasma ATⅡ levels were measured by radioimmunoassay and serum IFN-γ, IL-4 and IL-17 levels by ELISA. Results: The levels of ATⅡ, IFN-γ and IL-17 were significantly increased in the early renal damage group compared with those in the non-renal injury group and the control group. There was no significant difference in the levels of IL-4 among the 3 groups There was a positive correlation between the level of IFN-γand IL-17, but not with the level of IL-4. CONCLUSION: High ATⅡ levels in patients with essential hypertension lead to changes in the effector T lymphocyte subsets, resulting in the upregulation of Th1 and Th17 functions and the development of early renal impairment.