高血压左室肥厚与细胞离子转运和环核苷酸的关系

目的：探讨血流动力学、细胞阳离子转动和环核苷酸在高血压左心室肥厚（LVH）发生中的作用。方法：采用30例正常人和45例高血压非LVH病人双重同期对照，观察45例高血压LVH病人的血压、外周阻力，淋巴细胞ATP酶活性，阳离子和环核苷酸变化。结果：高血压LVH和非LVH病人血压、外周阻力、细胞离子转运和环核苷酸均有异常；高血压LVH组收缩压、细胞Na^ a^、Ca^ 、cAMP和cAMP/cGMP比值高于非LVH组，细胞Na^ ，K^ -三磷酸腺苷酶（Na^ －K^ －ATPase)、Ca^ －ATPase活性和K^ 低于非LVH组。左室重量指数（LVMI）与Ca^ －ATPase、Na^ 、cAMP和cAMP/cGMP比值相关。逐步回归分析显示，在16个相关预选因子中，Na^ 、Ca^ －ATPase、Mg^ ,cAMP与LVMI之间有独立的相关关系。结论：血流动力学、细胞阳离子转运和环核苷酸变化参与高血压LVH的发病过程，其中Na^ 、Ca^ －ATPase、Mg^ 和cAMP可能起重要作用。

Effects of Cellular Cation Transport and Cyclic Nucleotides on Left Ventricular Hypertrophy in Essential Hypertension

Aim To investigate the roles of hemodynamics,cellular cation transport and cyclic nucleotides in left ventricular hypertrophy (LVH) of essential hypertension (EH) . Methods\ By studying 30 normal subjects and 45 EH patients without LVH as double concurrent controls, blood pressure, total peripheral resistance, lymphocytic adenosine triphosphatase (ATPase) and cations and cyclic nucleotides were determined in 45 EH patients with LVH. Results\ Systolic blood pressure, lymphocytic Na\ , Ca 2 , cAMP and cAMP/cGMP ratio were higher in EH patients with LVH than those in EH patients without LVH, lymphocytic Na K ATPase and Ca 2 ATPase, K were lower in EH patients with LVH than those in patients without LVH. Mg 2 in EH patients with LVH was lower than in normal subjects. Left ventricular mass index was correlated with Ca 2 ATPase, Na , cAMP and cAMP/cGMP ratio. Multiple stepwise regression analysis revealed that Na , Ca 2 ATPase, Mg 2 and cAMP were the independent factors affecting LVH in 16 parameters. Conclusions\ The changes of hemodynamics, cellular cation transport and cyclic nucleotides might be involved in the pathophysiologic mechanisms of LVH in EH. Na , Ca 2 ATPase, Mg 2 and cAMP may play more important parts in LVH.