H型高血压患者血清淀粉样蛋白A和载脂蛋白B/A1与颈动脉内膜中层厚度的关系

Relationship of serum amyloid A, apolipoprotein B/A1 ratio with carotid intima-media thickness in H-type hypertension

目的探讨血清淀粉样蛋白A(SAA)和载脂蛋白B/A1(ApoB/A1)与H型高血压患者颈动脉内膜中层厚度(IMT)的关系。方法入选2016年8月至2017年12月就诊的高血压患者526例[正常同型半胱氨酸(Hcy)271例,高Hcy 255例],另选取同期体检的正常血压者300人(正常Hcy者138人,高Hcy者162人)为对照组。研究对象均进行一般情况调查,采用彩色多普勒超声诊断仪测量颈动脉IMT,胶乳增强比浊法检测SAA和高敏C反应蛋白(hsCRP),循环酶法检测Hcy,免疫比浊法检测ApoB、ApoA1并计算ApoB/A1。多元逐步回归法分析颈动脉IMT与各影响因素的相关性。结果高血压高Hcy组IMT[(1.68±0.63)mm]、Hcy[(19.72±4.6)μmol/L]、SAA[(16.75±6.83)mg/L]、ApoB/A1[(1.03±0.24)]高于正常血压正常Hcy组[(0.84±0.21)mm,(7.72±1.11)μmol/L,(3.60±1.28)mg/L,(0.71±0.10)]、正常血压高Hcy组[(1.38±0.56)mm,(17.83±2.16)μmol/L,(10.89±2.25)mg/L,(0.92±0.23)]和高血压正常Hcy组[(1.43±0.54)mm,(11.77±2.05)μmol/L,(10.85±7.82)mg/L,(0.90±0.22);均P<0.05]。Pearson相关分析显示,受试者Hcy与颈动脉IMT呈正相关(r=0.649,P<0.001)。多元逐步线性回归分析显示,ApoB/A1、SAA、Hcy是高血压患者颈动脉IMT的影响因素。结论血清SAA和ApoB/A1是H型高血压患者颈动脉IMT增加的影响因素。

Objective To study the relationship between serum amyloid A(SAA),apolipoprotein B/A1 ratio(ApoB/A1)and carotid intima-media thickness(IMT)in H-type hypertension patients.Methods A total of 526 hypertensive patients[271 with normal homocysteine(Hcy)and 255 with high Hcy],and 300 normtensive patients(138 with normal Hcy and 162 with high Hcy)attended to the First Hospital of Nanping Affiliated to Fujian Medical University from August 2016 to December 2017 were enrolled.All the subjects were conducted general investigation.IMT was measured by Doppler ultrasonic scanner.SAA and high sensitivity C-reactive protein(hsCRP)were measured by latex enhanced immunoturbidimetric assay.Hcy was measured by cycling enzymatic method.Apolipoprotein B(ApoB),apolipoprotein A1(ApoA1)were measured by immunoturbidimetric assay,and ApoB/A1 was calculated.The correlations between IMT and Hcy,SAA,ApoB/A1 were analysed by multiple stepwise regression analysis.Results IMT[(1.68±0.63)mm],Hcy[(19.72±4.60)μmol/L],SAA[(16.75±6.83)mg/L]and ApoB/A1(1.03±0.24)of hypertensives with Hcy were higher than that normotensives with normal Hcy[(0.84±0.21)mm,(7.72±1.11)μmol/L,(3.60±1.28)mg/L,(0.71±0.10)],normotensives with normal Hcy[(1.38±0.56)mm,(17.83±2.16)μmol/L,(10.89±2.25)mg/L,(0.92±0.23)]and hypertensives with normal Hcy[(1.43±0.54)mm,(11.77±2.05)μmol/L,(10.85±7.82)mg/L,(0.90±0.22);all P<0.05].Pearson analysis showed that IMT was positively related with Hcy(r=0.649,P<0.001).Multiple stepwise linear regression analysis showed that ApoB/A1,SAA and Hcy were the most related factors of increased IMT in hypertension.Conclusion In H-type hypertension,SAA and ApoB/A1 are the most related factors of increased carotid IMT.