【摘要 】 目的 测定高血压病(EH)患者血清I型前胶原羧基端肽(PIP)水平,探讨其临床意义。方法 采用放射免疫分析方法测定48例EH患者和30例正常血压(NH)的健康人血清PIP的水平,并用超声心动图测量左室解剖、舒缩功能参数。动态心电图(DCG)记录EH组室性心律失常程度，并以Lown-wolf法分级。结果 EH组血清PIP浓度较对照组显著升高(6.91±0.62μg/L vs 4.8±0.38μg/L,P<0.01)。在EH并左室肥厚者，血清PIP浓度与左室质量指数正相关(LVMI)(r=0.5163,P<0.05),与左室舒张功能呈负相关(r=-0.5734,P<0.05)。EH组Lown-wolf分级3级以上室性心律失常者血清PIP水平较0～2级明显升高(7.25±0.37μg/L vs 6.11±0.54μg/L,P<0.05) 。结论 EH患者可能有心肌局部I型胶原合成增加,测定血清PIP浓度可作为了解心肌纤维化程度的间接指标。

Significance of increased serum procollagen type I carboxy terminal peptide in essential hypertension

Liu Chengyun, Yang Qunfang, Wang Lin, et al. Union Hospital, Tongji Medical University, Wuhan 430022

【Abstract 】 Objectives To evaluate the clinical significance of serum procollagen type Icarboxy terminal peptide (PIP) in patients with essential hypertension (EH). Methods The serum concentratin of PIP was measured by specificradioimmunoassay in EH patients (n=48) and in normotensive control subjects (NH,n=30).Two-diamensional, M-mode and Doppler ultrasound recordings were obtained in every subjectto determine serveral parameters of left ventricular anatomy and function. Ambulatory ECGmonitoring was performed in EH patients to record the ventricular arrhythmias which werecategorized according to Lown-Wolf classification. Results Serum concentration of PIP was markedly higher in EHpatients (6.91±0.62μg/L vs 4.8±0.38 μg/L,P<0.01) than in normal subjects (6.91±0.62 μg/L vs 4.8±0.38 μg/L,P<0.01) and it was correlated positively with the left ventricular mass index (LVMI, r=0.5163, P<0.05) and negatively with the left ventricular diastolic function (P<0.05) in EH patients with LV hypertrophy. The serum concentration of PIP was significantly higher (r=-0.5734, P<0.05)in ventricular arrhythmic patients of>grade Ⅲ thanthat in those of grade 0 ～Ⅱ (7.25±0.37 μg/lvs 6.11±0.54 μg/L, P<0.05). Conclusion The finding suggests that the synthesis of myocardial collagen typeI may be abnormally increased in patient with EH, and thus serum PIP might be an indirectindex of hypertensive myocardial fibrosis.

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