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目的探讨原发性高血压病患者外周血淋巴细胞活性氧自由基(ROS)水平变化与血压昼夜节律的关系。方法选择2014年5月至2016年1月62例原发性高血压患者作为研究对象,行24 h动态血压监测,记录24 h平均收缩压及舒张压、白天平均收缩压及舒张压、夜间平均收缩压及舒张压等,按照血压昼夜变化分为杓型血压组(n=21)、非杓型血压组(n=24)及反杓型血压组(n=17),应用二氯荧光黄双乙酸盐(DCFH-DA)探针标记外周血淋巴细胞ROS,采用流式细胞术检测ROS水平[脱氧助间型霉素(DCF)平均荧光强度]。同时以18例同期进行健康体检血压正常的成年人作为对照。结果高血压患者包括杓型血压组、非杓型血压组及反杓型血压组淋巴细胞ROS水平较对照组均显著增加(P均<0.05),其DCF荧光强度分别为:杓型血压组546.35±30.29,非杓型血压组567.63±35.35,反杓型血压组591.68±38.57,两两比较均有统计学差异(P均<0.05)。相关性分析显示淋巴细胞ROS水平与夜间平均收缩压及夜间平均舒张压呈显著正相关(r=0.451,r=0.425,P均<0.05),与白天平均舒张压呈负相关(r=-0.218,P<0.05)。结论高血压患者外周血淋巴细胞ROS水平增加,且与杓型高血压患者比较,非杓型和反杓型高血压患者淋巴细胞ROS水平进一步增加,且夜间血压的升高与患者外周血淋巴细胞ROS水平增加相关,提示淋巴细胞ROS改变与血压昼夜异常相关,。
Objective To investigate the relationship between changes of reactive oxygen species (ROS) in peripheral blood lymphocytes and circadian rhythm of blood pressure in patients with essential hypertension. Methods Sixty-two patients with essential hypertension from May 2014 to January 2016 were enrolled in this study. Ambulatory blood pressure monitoring was performed at 24 hours. The mean systolic and diastolic blood pressure at 24 hours, mean systolic and diastolic blood pressures during the day, and nighttime mean (N = 21), non-dipper blood pressure group (n = 24) and anti-dipper blood pressure group (n = 17) according to the diurnal variation of blood pressure. (DCFH-DA) probe labeled peripheral blood lymphocytes ROS, ROS levels were measured by flow cytometry [deoxycoformycin (DCF) average fluorescence intensity]. At the same time, 18 healthy adults with normal blood pressure during the same period were taken as control. Results The levels of ROS in the non-dipper group and the anti-dipper group were significantly higher than those in the control group (P <0.05), and the DCF fluorescence intensity of the group with dipper blood pressure was 546.35 ± 30.29, non-dipper blood pressure group 567.63 ± 35.35, anti-dipper blood pressure group 591.68 ± 38.57, there was a statistically significant difference (all P <0.05). Correlation analysis showed that the level of ROS in lymphocytes was significantly and positively correlated with nighttime mean systolic pressure and nighttime mean diastolic pressure (r = 0.451, r = 0.425, P <0.05), and negatively correlated with daytime mean diastolic pressure (r = -0.218 , P <0.05). CONCLUSIONS: The levels of ROS in peripheral blood lymphocytes are increased in patients with hypertension, and compared with those in patients with dipper hypertension, the levels of ROS in lymphocytes are further increased in non-dipper and anti-dipper patients, and the increase of nocturnal blood pressure and peripheral blood lymphocytes ROS levels increased, suggesting that changes in lymphocytes ROS and abnormal blood pressure day and night.