C-反应蛋白与血压和TCD参数的相关性

The association among C-reactive protein and blood pressure and the parameters of transcranial doppler

目的了解C-反应蛋白(CRP)与血压和TCD之间的关系。方法从2008年体检人群中选取1286名调查对象,按CRP值将调查对象分为低危组(CRP<3mg/L)936例,中危组(CRP3～10mg/L)240例和高危组(CRP>10mg/L)110例;分析各组年龄和TCD各指标的差异,比较不同组别高血压患者的构成比例,采用多因素Logistic回归分析高血压患者构成比例与不同CRP水平之间的相关性。结果与低危组比较,高危组和中危组左侧大脑中动脉和基底动脉的平均流速、舒张期流速明显降低(P<0.05),双侧大脑中动脉和基底动脉搏动指数、阻力指数有明显差异(P<0.05),患病年龄也明显增大(P<0.05)。高危组(62.73%)和中危组(50.83%)患高血压的比例比低危组(37.82%)增加明显,患高血压的危险度分别是低危组的4.450倍(95%CI:2.967～6.674)和2.734倍(95%CI:2.064～3.621)。结论高水平的CRP能降低大脑中动脉和基底动脉血管弹性,诱导其动脉硬化的发生。同时,人群中患高血压的患者和风险也随之增加。

Objective To investigate the association among C-reactive protein（CRP） and blood pressure and the parameters of transcranial doppler （TD）. Methods The data was collected from subjects（n=1 286）for annual physical evaluations of 2008 in the Public Health Center of the First Affiliated Hospital of Chongqing Medical University in Chongqing. The datas were randomized by multi-step cluster sampling methods. Subjects were divided into three groups according levels of CRP：（1） low-risk group：all subjects’ （n=936） levels of CRP were below 3 mg/L （2） midrange-risk group：all subjects’ （n=240） levels of CRP were between 3 mg/L and 10 mg/L;（3） high-risk group：all subjects’ （n=110） levels of CRP were more than 3 mg/L. The variables on subjects selected for this study were parameters of TD,the age of each group,proportionate of hypertension and the association between hypertension and leves of CRP were analyzed.Results The mean glow velocity,relaxing period velocity,pulsatility index and resistent index were significantly lower in high-risk group and midrange-risk group （P0.05.vs low-risk group）;the age of those groups was obviously older compared with those in low-risk group. The proportions of hypertension were significantly higher in high-risk group（62.73%） and midrange-risk group（50.83%） compared to low-risk group（37.82%）.The probabilities of hypertension in high-risk group（OR=4.450 CI：2.967～6.674） and midrange-risk group（OR=2.734 CI：2.064～3.621） were higher than that of low-risk group. Conclusions High level of CRP can cut down the elasticity of middle cerebral artery and basilar artery,induce the appearance of arteriosclerosis in both arteries. High level of CRP also can improve the risk of hypertension.