高敏C反应蛋白及脉压与老年高血压患者动脉粥样硬化相关性探讨

Correlation between hyper-sensitivity C-reactive protein,pulse pressure and atherosclerosis in elderly essential hypertension patients

目的探讨高敏C反应蛋白(hs-CRP)及脉压(PP)与老年原发性高血压(EH)患者动脉粥样硬化(AS)的相关性。方法对106例老年EH患者进行hs-CRP浓度测定,同时测量血压,并使用B型超声测定颈动脉内膜中层厚度(IMT)及斑块,根据IMT及斑块将患者分为非IMT增厚组(32例)和IMT增厚组(74例),结合hs-CRP及PP对两组患者进行比较和综合分析。结果IMT增厚组hs-CRP及PP显著高于非IMT增厚组(P<0.05,P<0.01),粥样斑块Ⅰ、Ⅱ、Ⅲ级hs-CRP及PP显著高于粥样斑块0级(P<0.05,P<0.01),并且IMT与hs-CRP及PP呈显著正相关,IMT增厚组相关系数分别为0.742和0.638(P<0.05,P<0.01),非IMT增厚组相关系数分别为0.553和0.425(P<0.05,P<0.01),所有患者相关系数分别为0.679和0.538(P<0.05,P<0.01)。进一步行多因素logistic多元回归分析,结果显示,hs-CRP、PP、收缩压与IMT增厚呈正相关。结论血清hs-CRP及PP水平与老年EH患者AS发病密切相关。

Objective To explore the relationship between high-sensitivity C-reactive protein（hs-CRP）, pulse pressure（PP） and atherosclerosis in elderly essential hypertension（EH） patients. Methods One hundred and six elderly EH patients were selected, hs-CRP was determined, blood pressure was measured and B-mode uhrasound was used to measure carotid intima-media thickness（IMT） and the plaque of carotid artery. The patients were divided into two groups according to the IMT and the plaque of carotid artery. IMT and the plaque of carotid artery were compared and analyzed in conjunction with hs-CRP and PP. Results hs-CRP and PP were higher in the IMT thickened group than in IMT not thickened group（ P 〈 0.05, P 〈0.01）. hs-CRP and PP were also higher in carotid artery plaque class Ⅰ , Ⅱ , Ⅲ groups than in noplaque groups （ P 〈 0.05, P 〈 0.01）. There were positive correlations between IMT and hs-CRP, PP in the IMT thickened group （r = 0.742, 0.638,P 〈0.05,0.01 respectively） and IMT not thickened group（ r = 0.553,0.425,P 〈 0.05, P 〈 0.01 respectively）and there were positive correlations between IMT and hs-CRP, PP in all elderly EH patients （ r = 0.679,0.538, P 〈 0.05, P 〈 0.01 respectively）. Multivariate logistic regression analysis showed that IMT thickening was positively correlated with hs-CRP, PP, SBP. Conclusion The levels of serum hs-CRP and PP were closely correlated with atherosclerosis and plaque genesis in elderly EH patients.