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目的探讨急性口服盐水负荷对高血压盐敏感者肾脏前列环素(PGI2)及血栓皖素A2(TXA2)的代谢变化及其与早期肾损害的相关性。方法采用改良的Sullivan s法将2006—2009年福建省心血管病研究所心内科150例高血压患者分为盐敏感性(SS,83例)和非盐敏感性(NSS,67例)高血压组;采用放射免疫法测定尿白蛋白(Alb)及盐水负荷前后TXA2、PGI2的代谢产物TXB2、6-酮-PGF1α并对二者行相关分析。结果 SS组晨尿Alb/肌酐(Scr)显著高于NSS组,差异有统计学意义(P<0.05),口服盐水负荷后2 h,盐敏感者6-酮-PGF1α浓度明显较盐不敏感者低(P<0.05);而盐负荷后盐敏感者TXB2浓度、TXB2/6-酮-PGF1α及负荷后的增加幅度均明显较盐不敏感者高,TXB2/6-酮-PGF1α盐负荷后2 h显著,差异有统计学意义(P<0.05)。TXB2/6-酮-PGF1α与尿Alb/Scr呈显著正相关(r=0.267,P<0.05)。结论盐负荷对高血压盐敏感及盐不敏感者肾脏TXA/PGI代谢的影响有明显差异,与盐敏感性高血压早期肾损害有关。
OBJECTIVE: To investigate the metabolic changes of renal PGI2 and TXA2 and its relationship with early renal damage induced by acute oral salt load in hypertensive salt-sensitive subjects. Methods A total of 150 hypertensive patients with cardiopathy from 2006 to 2009 in Cardiology Institute of Fujian Province were divided into salt sensitivity (SS, 83 cases) and non-salt-sensitive (NSS, 67 cases) hypertension by modified Sullivan’s method. Group; TXB2, TXB2 and PGI2 metabolites TXB2, TXB2 and PGI2 before and after saline load were assayed by radioimmunoassay and their correlation analysis was performed. Results The morning urine Alb / creatinine (Scr) in SS group was significantly higher than that in NSS group (P <0.05). The concentration of 6-keto-PGF1α in salt sensitive group was significantly lower than that in salt- (P <0.05). After salt loading, the levels of TXB2, TXB2 / 6-keto-PGF1α and post-loading rates of salt-sensitive individuals were significantly higher than those of salt-sensitive ones h significantly, the difference was statistically significant (P <0.05). TXB2 / 6-keto-PGF1α was positively correlated with urinary Alb / Scr (r = 0.267, P <0.05). Conclusions The effect of salt load on renal TXA / PGI metabolism in hypertensive salt-sensitive and salt-insensitive groups is significantly different, which is related to the early renal damage in salt-sensitive hypertensive patients.