Intervention Study Of Aldosterone Antagonist On Essential Hypertensive Immuno-inflammatory Injury

Objective: To investigate the relationship between the expression of T lymphocyte subsets and left ventricular structure and function in peripheral blood of patients with essential hypertension(EH)and the intervention of aldosterone antagonists.Methods: Choose 60 patients with EH from August 2015 to August 2016 in our hospital.Including 37 males and 23 females,aged 60 to 78 years,mean age 66.8 ± 5.6(years),Were randomly divided into the Conventional antihypertensive group(n = 30 cases)and30 patients with conventional antihypertensive plus spironolactone as the Spironolactone intervention group(n = 30 cases),aged 60 to 80 years,mean age 64.4 ±5.9(years),;another 30 healthy subjects were selected as the health group,There was no significant difference in age and sex between the two groups(p> 0.05).The percentage of total T lymphocyte(CD3 +),the percentage of CD4+T lymphocytes(CD3 + CD4+),the percentage of CD8+T lymphocytes(CD3 + CD8 +),and the ratio of CD4 + /CD8 + were measured by flow cytometry.(2)The use of color echocardiography to determine left ventricular structure and function.SPSS19.0 statistical software was used to analyze the data.The data were first subjected to single sample normality and variance homogeneity test in nonparametric test.The data of the normal distribution of each group were expressed as mean ± standard deviation.Two groups of independent samples were taken between the two groups.The chi-square test(χ 2)was used betweenthe two groups.The pearson correlation coefficient analysis.Determination of P value,P <0.05 was statistically significant.Results: Compared with the health group,the ratio of CD3 + CD4 + T lymphocytes and CD4 + / CD8 + in peripheral blood of patients with hypertension was significantly higher than that of health group(P <0.05),while total T lymphocytes(CD3 +),CD3 +CD8 + T lymphocytes And the difference between the health group was not statistically significant(P> 0.05)。EH patients after 6 months of treatment,There was no significant difference in the total T lymphocytes(CD3 +)between the two groups(P> 0.05).The CD3+CD4+T lymphocytes and CD4+/CD8+ in the Spironolactone intervention group were significantly lower than those in the Conventional antihypertensive group(P<0.05)。 left ventricular posterior wall(LVPW)thickness,ventricular septum(IVS)thickness,early mitral flow velocity and atrial systolic velocity(E / A)were significantly different from those in the Conventional antihypertensive group(P <0.05),There was no significant difference in ejection fraction(LVEF)between the two groups(P> 0.05)。 CD4 + / CD8 + was negatively correlated with E / A(r =-0.57,P <0.05),and the percentage of CD4 + T lymphocytes was positively correlated with LVPW(r =0.52,P <0.05).Conclusion: 1.Patients with hypertension have immune dysfunction2.Aldosterone antagonists may improve the left ventricular function in hypertensive patients by inhibiting the inflammatory response of the blood vessels and regulating the immune subpopulation.