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目的观察正常高值血压(PH)患者血清脂质过氧化水平的变化,探讨其在高血压治疗和预防方面的意义。方法按照JNC7诊断标准筛选出PH患者106例,原发性高血压(EH)患者91例,同时随机挑选血压正常健康人(NT)98例作为对照。采用生化法测定血清中超氧化物歧化酶(SOD),谷胱甘肽过氧化物酶(GSH-PX),丙二醛(MDA),过氧化脂质(LPO)的含量。结果PH组患者血中总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)及体质量指数(BMI)明显高于NT组(P<0.05或0.01)。PH组和EH组血清MDA、LPO明显高于NT组[MDA,PH组(13.8±2.2),EH组(18.9±2.0)比NT组(10.5±1.3)μmol/L,分别为P<0.05和P<0.01];[LPO,PH组(2.4±0.4),EH组(2.8±0.4)比NT组(1.9±0.2)μmol/L,分别为P<0.05和P<0.01]。PH组血清GSH-PX明显高于NT组,EH组却明显低于NT组[GSH-PX,PH组(0.22±0.04)比NT组(0.20±0.03)μmol/L,P<0.05;EH组(0.18±0.04)比NT组(0.20±0.03)μmol/L,P<0.05]。PH组和EH组血清SOD都较NT组低[SOD,PH组:(72.4±10.7)、EH组:(65.1±10.0)比NT组(79.0±10.2)U/mL,分别为P<0.05和P<0.01];多因素logistic回归分析,正常高值血压与BMI、GSH-PX、MDA、LPO呈正相关(β为0.496、1.768、1.565、1.204;分别为P<0.05、P<0.05、P<0.01、P<0.01)。正常高值血压与SOD呈负相关(β为-0.115,P<0.05)。结论正常高值血压患者血清SOD下降、GSH-PX上升、MDA、LPO等过氧化产物增高,提示正常高值血压患者体内氧化应激增强。
Objective To observe the changes of serum lipid peroxidation in patients with normal high blood pressure (PH) and to explore its significance in the treatment and prevention of hypertension. Methods According to the JNC7 diagnostic criteria, 106 patients with PH and 91 patients with essential hypertension (EH) were screened, and 98 healthy subjects (NT) were randomly selected as control. Serum levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malondialdehyde (MDA) and lipid peroxidation (LPO) were determined by biochemical methods. Results The total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and body mass index (BMI) in PH group were significantly higher than those in NT group (P <0.05 or 0.01). The levels of serum MDA and LPO in PH group and EH group were significantly higher than those in NT group [MDA, PH group (13.8 ± 2.2), EH group (18.9 ± 2.0) vs NT group (10.5 ± 1.3) μmol / L, P < P <0.01]; [LPO, PH group (2.4 ± 0.4), EH group (2.8 ± 0.4) vs NT group (1.9 ± 0.2) μmol / L, P <0.05 and P <0.01, respectively]. The level of GSH-PX in PH group was significantly higher than that in NT group (P <0.05), while the level in EH group was significantly lower than that in NT group [GSH-PX, 0.22 ± 0.04 vs 0.20 ± 0.03 μmol / L, (0.18 ± 0.04) than NT group (0.20 ± 0.03) μmol / L, P <0.05]. The serum SOD of PH group and EH group were lower than that of NT group [P <0.05 and P <0.05, respectively, compared with NT group (72.4 ± 10.7), EH group (65.1 ± 10.0) and NT group (79.0 ± 10.2) U / P <0.01]; multivariate logistic regression analysis showed that normal high blood pressure was positively correlated with BMI, GSH-PX, MDA and LPO (β = 0.496,1.768,1.565,1.204; P <0.05, P < 0.01, P <0.01). Normal high blood pressure was negatively correlated with SOD (β = -0.115, P <0.05). Conclusion Serum SOD, GSH-PX and MDA, LPO and other peroxidation products are increased in patients with normal high blood pressure, suggesting that the oxidative stress in patients with normal high blood pressure is enhanced.