發(fā)布時(shí)間：2018-04-10 00:36

  本文選題：高血壓　切入點(diǎn)：運(yùn)動(dòng)試驗(yàn)　出處：《桂林醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討運(yùn)動(dòng)試驗(yàn)中血壓變化與高血壓患者靶器官的損傷與血漿及外周血單個(gè)核細(xì)胞(PBMC)中microRNAs表達(dá)的關(guān)系。方法:篩選90例高血壓患者,根據(jù)運(yùn)動(dòng)試驗(yàn)中患者血壓升高水平,將其分為運(yùn)動(dòng)性高血壓組(55例)和普通高血壓組(35例),另選取普通健康人20名作為正常對(duì)照組。記錄所有患者靜息時(shí)、運(yùn)動(dòng)最大負(fù)荷時(shí)和運(yùn)動(dòng)停止后2、6、10 min的收縮壓和舒張壓,檢測(cè)其亞臨床靶器官損傷相關(guān)指標(biāo)[左心室質(zhì)量指數(shù)(LVMI)、頸動(dòng)脈內(nèi)中膜厚度(IMT)、估算的腎小球?yàn)V過(guò)率(eGFR)、尿微量清蛋白水平],并應(yīng)用實(shí)時(shí)熒光定量PCR測(cè)定血漿和PBMC中microRNA(microRNA-145、microRNA-143、microRNA-21)的表達(dá)水平。結(jié)果:3組運(yùn)動(dòng)最大負(fù)荷時(shí)和運(yùn)動(dòng)停止后2 min時(shí)的收縮壓和舒張壓分別顯著高于同組靜息時(shí)(P值均0.05),運(yùn)動(dòng)停止后6、10 min時(shí)的收縮壓和舒張壓分別顯著低于同組運(yùn)動(dòng)最大負(fù)荷時(shí)(P值均0.05);收縮壓變化幅度較舒張壓明顯。運(yùn)動(dòng)性高血壓組的LVMI、頸動(dòng)脈IMT、eGFR、尿微量白蛋白水平均顯著高于正常對(duì)照組和普通高血壓組(P值均0.05)。普通高血壓組和運(yùn)動(dòng)性高血壓組血漿中microRNA-145表達(dá)水平均顯著低于正常對(duì)照組(P值均0.05),運(yùn)動(dòng)性高血壓組血漿中microRNA-145表達(dá)水平顯著低于普通高血壓組(P0.05);3組間血漿中microRNA-143表達(dá)水平的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P值均0.05),普通高血壓組血漿中microRNA-21表達(dá)水平顯著高于正常對(duì)照組和運(yùn)動(dòng)性高血壓組(P值均0.05)。普通高血壓組和運(yùn)動(dòng)性高血壓組PBMC中microRNA-145、microRNA-143表達(dá)水平均顯著低于正常對(duì)照組(P值均0.05),運(yùn)動(dòng)性高血壓組PBMC中microRNA-145、microRNA-143表達(dá)水平均顯著低于普通高血壓組(P值均0.05);普通高血壓組和運(yùn)動(dòng)性高血壓組PBMC中microRNA-21表達(dá)水平均顯著高于正常對(duì)照組(P值均0.05),運(yùn)動(dòng)性高血壓組PBMC中micro RNA-21表達(dá)水平顯著低于普通高血壓(P0.05)。結(jié)論:運(yùn)動(dòng)性高血壓可被視為評(píng)估靶器官損傷相關(guān)指標(biāo)血壓與靶器官損傷之間聯(lián)系的一個(gè)重要因素,運(yùn)動(dòng)性高血壓患者、普通高血壓患者和健康人的血漿和PBMC中的microRNA表達(dá)存在差異。
[Abstract]:Aim: to investigate the relationship between changes of blood pressure in exercise test and target organ injury in patients with hypertension and the expression of microRNAs in plasma and peripheral blood mononuclear cells (PBMCs).Methods: 90 patients with hypertension were selected and divided into exercise hypertension group (55 cases) and normal hypertension group (35 cases) according to the elevated level of blood pressure in exercise test.Systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded in all patients at rest, at maximum exercise load and 2 minutes after exercise stoppage for 10 min.The subclinical target organ injury related indexes (left ventricular mass index (LVMI), carotid intima-media thickness (IMT), estimated glomerular filtration rate (GFR), urine microalbumin level) were measured. The expression of microRNA-145microRNA-143microRNA-21 in plasma and PBMC was measured by real-time fluorescence quantitative PCR.Results systolic blood pressure and diastolic blood pressure were significantly higher at maximum exercise load and 2 min after exercise cessation than at rest in the same group (P = 0.05). Systolic blood pressure and diastolic pressure at 6 minutes and 10 min after exercise cessation were significantly lower than those at exercise peak in the same group.At high load, P value was 0.05 and the change of systolic blood pressure was more obvious than that of diastolic pressure.LVMI, IMT IMT eGFR and urinary microalbumin levels in exercise induced hypertension group were significantly higher than those in normal control group and normal hypertension group (P < 0.05).The expression of microRNA-145 in plasma of normal hypertension group and exercise hypertension group was significantly lower than that of normal control group (P < 0.05), and that of exercise induced hypertension group was significantly lower than that of normal hypertension group (P 0.05). The expression of microRNA-143 in exercise induced hypertension group was significantly lower than that in normal hypertension group (P 0.05).There was no significant difference in the level of microRNA-21 between the two groups. The expression of microRNA-21 in the plasma of the normal hypertension group was significantly higher than that of the normal control group and the exercise induced hypertension group.The expression level of microRNA-145 microRNA-143 in PBMC in normal hypertension group and exercise hypertension group was significantly lower than that in normal control group (P < 0.05), and the expression level of microRNA-145 microRNA-143 in PBMC in exercise hypertension group was significantly lower than that in normal hypertension group (P < 0.05), while in normal hypertension group, the expression level of microRNA-145 microRNA-143 was significantly lower than that in normal hypertension group (P < 0.05).The expression of microRNA-21 in PBMC and exercise induced hypertension group was significantly higher than that in normal control group (P < 0.05). The expression of micro RNA-21 in PBMC in exercise induced hypertension group was significantly lower than that in normal hypertension group (P 0.05).Conclusion: exercise induced hypertension can be regarded as an important factor in evaluating the relationship between blood pressure and target organ injury.The expression of microRNA in plasma and PBMC was different between normal hypertension patients and healthy people.
【學(xué)位授予單位】：桂林醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R544.1

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