Статья
Показатели функции печени при артериальной гипертензии (обзор литературы)
Актуальность. У лиц с артериальной гипертензией (АГ) регистрируются более высокие маркеры функции печени, а также при повышенных показателях функции печени отмечается более высокий риск АГ. Нарушение функции печени рассматривается как фактор, способствующий развитию АГ. Цель исследования. В статье особое внимание уделено таким показателям функции печени, как альбумин, щелочная фосфатаза (ЩФ), аланинаминотрансфераза (АЛТ), аспартатаминотрансфераза (АСТ), гамма-глутамилтранспептидаза (ГГТП), сывороточный билирубин, лактатдегидрогеназа (ЛДГ), протромбиновое время (ПВ), и их роли при АГ. Результаты. Повышение уровня альбумина от 40 до 50 г/л в пределах физиологических колебаний коррелирует с повышением систолического артериального давления на 5–11 мм рт. ст. у мужчин и на 6–17 мм рт. ст. у женщин. Также показана отрицательная связь между сывороточным уровнем ЩФ и показателями анатомии и функции артерий у африканцев. Обратная связь выявлена между уровнем АЛТ и АГ во взрослой китайской когорте, что дает основания предположить, что повышение уровня АЛТ может предшествовать развитию АГ. В целом встречаемость повышенного уровня АЛТ и АСТ среди первокурсников составила 6,8 % и 2,3 % соответственно. Повышение уровня ГГТП ассоциировано с увеличением риска АГ. У мужчин с предгипертензией (но не у нормотензивных лиц) уровень билирубина в сыворотке крови отрицательно коррелировал с показателями жесткости артерий. У женщин такой связи выявлено не было. Повышение уровня ЛДГ в сыворотке крови было ассоциировано с АГ беременных и развитием осложнений как со стороны матери, так и со стороны плода. Систолическое и диастолическое артериальное давление положительно коррелировало с активированным частичным тромбопластиновым временем (АЧТВ) у лиц с АГ. Можно предположить, что ПВ и АЧТВ могут использоваться как показатели нарушений в системе свертывания крови у лиц с АГ для коррекции терапии. Конкретные механизмы, через которые печеночные маркеры влияют на уровень артериального давления и риск АГ, до конца неясны.
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