| Background and PurposeHypertension is one of the major diseases of endanger public health, the main factors leading to stroke, coronary heart disease, heart failure, kidney disease, and others. Since the founding of New China, with economic growth and development of the living standard of the people, the prevalence and total mortality of hypertension increased year by year. According to the causes hypertension can be divided into: essential hypertension and certain diseases caused by the secondary hypertension, which accounts for about 95% of essential hypertension. Essential hypertension is recognized a multi-gene and multi-factor of genetic, chronic diseases, caused by genetic factors and environmental factors. Because hypertension is a complex disease by the genetic susceptibility and environmental factors determined, some risk factors and pathogenesis has been basically clear, but, ANP, BNP, ACE2, and IL-10 of roles in the process are further explore, the signs indicate that they have a close relationship between the development of hypertension. This study was to determine serum levels of ANP, BNP, ACE2, and IL-10 of 113 hypertensive patients, to understand their expression in this disease, while observing the correlation between course of hypertension, biochemical markers, ultrasonography results and their expression, for clarify the etiology and pathogenesis of hypertension, further diagnosis and treatment of the disease, provide a new and meaningful way.Materials and MethodsSelected 113 essential hypertensive patients as the test group hospitalized at the Branch of First Hospital of Jilin University, Department of Cardiology, from July 2008 to December 2009 (EH group), according to left ventricular end-diastolic diameter and left ventricular ejection fraction, EH may be divided into non-Left ventricular systolic dysfunction groups (non-HF group) and hypertension with left ventricular systolic dysfunction group (HF group). During the same period 60 cases of outpatient and inpatient by the detailed examination without hypertension and other heart diseases as the healthy control group.Inclusion criteria: according to 1999 WHO / ISH classification of diagnostic criteria for hypertension treatment guidelines, hypertension is defined as SBP≥140mmHg and / or DBP≥90mmHg. Cardiac function classification reference to NYHA standards: They have symptoms of congestive heart failure, cardiac ultrasonography showed LVDD increased (male≥55mm, female≥50mm) associated with LVEF <50% for the systolic heart failure. Detailed record of sex, age, smoking history, drinking history, height, weight, course of hypertension, laboratory tests (liver function, kidney function, blood lipids), and echocardiography findings (left atrial diameter, left ventricular end-diastolic diameter, right ventricular dimensions, shortening fraction, ejection fraction) and so on. Serum IL-10,ANP,BNP levels were detected by ELISA from elbow 4ml in all selected persons in the early morning on an empty stomach. Statistical method: Test parameters and clinical data were measured by chisquare test, independent-samples T test, ANOVA, correlation analysis and stepwise regression analysis.result1. The ANP and BNP levels were significantly higher in hypertension group than in control group (P<0.05); Serum ANP and BNP levels in hypertensive patients with systolic heart failure were significantly higher than hypertensive with normal heart function (P<0.05).2. ACE2 levels were not significantly different in hypertension group and control group (P> 0.05); Serum ACE2 levels in hypertensive patients with systolic heart failure were significantly higher than hypertensive with normal heart function and control group(P<0.05).3. Serum IL-10 in hypertensive patients were significantly lower than the control group (P<0.05); Serum IL-10 levels in hypertensive patients with systolic heart failure were significantly higher than hypertensive with normal heart function (P<0.05).4. In the multiple stepwise regression analysis, ANP,BNP,ACE2 and IL-10were positively correlated with course of hypertension and left ventricular end-diastolic diameter (P<0.05) , and negatively correlated with left ventricular shorten fraction(FS) and ejection fraction(EF)(P<0.05).Conclusion1. ANP, BNP levels with hypertensive patients increased, indicating that hypertension can lead to ANP, BNP excessive secretion, and with the progress of the disease, and heart failure may increase the expression of both. That the development of hypertension during the ANP, BNP has continued to release,associated with the course and illnes of diseases, to clear the role of hypertension and monitoring of disease occurrence and development is important.2. Although ACE2 levels were not significantly different in hypertension group and control group, with the extended of course,increased in left ventricular diameter and occurrence of heart failure,ACE2 level was significantly increased. That ACE2 is a component of RAS, over released when the blood pressure sustained increase and cardiac function decline, for understanding the relationship between ACE2 and hypertension and to determine the severity of the disease are important.3. The incidence of hypertension associate with decline of IL-10 level; with the extended of course,increased in left ventricular diameter and occurrence of heart failure, IL-10 level was significantly increased, and it suggest that IL-10 as a inhibitor of inflammation involves in the incidence and development of hypertension,for the role of inflammation in hypertension has a positive meaning. |
PDF Full Text Request