高敏C反应蛋白与高血压病患者合并颈动脉粥样硬化的关系

Relationship between high-sensitivity C-reactive protein and carotid atherosclerosis in hypertensive patients

目的探讨炎症标记物高敏C反应蛋白(hs-CRP)与高血压病患者中颈动脉粥样硬化发生的关系。方法对入选的202例高血压病患者进行颈动脉超声检查测量颈总动脉内膜中层厚度(IMT)、观察有无斑块形成,并进行血清hs-CRP定量检测。根据患者颈动脉粥样硬化程度、是否合并糖尿病及吸烟情况分组进行血清hs-CRP水平比较。结果(1)合并颈动脉粥样硬化的高血压病患者血清hs-CRP显著高于无颈动脉粥样硬化患者[(4.96±5.26)mg/Lvs(3.16±3.54)mg/L,P=0.006]。(2)颈动脉斑块组患者平均血清hs-CRP显著高于颈动脉正常组患者[(5.35±4.82)mg/Lvs(3.16±3.54)mg/L,P=0.002]。(3)根据吸烟情况进行分层后,1年内有吸烟行为者中颈动脉斑块硬化组患者血清hs-CRP平均值明显高于颈动脉正常组[(5.30±5.02)mg/Lvs(3.07±1.70)mg/L,P=0.024]。(4)无糖尿病的高血压病患者中,颈动脉粥样硬化组患者血清hs-CRP均值高于颈动脉正常组[(5.03±5.35)mg/Lvs(3.25±3.61)mg/L,P=0.032]。结论合并颈动脉粥样硬化尤其有颈动脉斑块的高血压病患者血清hs-CRP显著高于无颈动脉粥样硬化患者。

Objective To investigate the relationship between high-sensitivity C-reactive protein （hs-CRP） and carotid atherosclerosis in hypertensive patients. Methods A tota of 202 patients with essential hypertension were enrolled in. All these patients were examined by B-mode ultrasound to measure intima-media thickness （IMT） and plaque formation. Serum hs-CRP of these patients were examined. Then the patients were divided into diabetes and smoking groups. Difference of serum hs-CRP between groups was analyzed. Results Serum hs-CRP was significantly higher in the group with carotid atherosclerosis （ P = 0.006）. It was higher in patients with carotid plaque than those with normal carotid （ P = 0. 002）. After demixing according to smoking, serum hs-CRP of patients with carotid atherosclerosis was higher and it was much higher in patients smoking recently （ P = 0. 024）. After demixing according to diabetes, serum hs-CRP of patients with carotid atherosclerosis was higher and it was much higher in patients without diabetes （ P = 0. 032）. Conclusion Serum hs- CRP is strongly associated with carotid atherosclerosis in hypertensive patients and is higher in patients with carotid atherosclerosis, especially in patients with plaque.