高血压患者颈动脉内中膜厚度与血清C-反应蛋白的相关性研究

Study on the correlation between carotid intima-media thickness and C-reactive protein in patients with hypertension

目的通过测定高血压病患者与健康正常人血清中C反应蛋白(CRP)浓度及颈动脉内中膜厚度(IMT),探讨高血压患者颈动脉粥样硬化与血清C反应蛋白的相关性。方法选择105例高血压病患者,其中男性55例,女性50例,平均年龄57.8±5.2岁,同时选择65例同期健康体检者作为对照组,其中男性36例,女性29例,平均年龄56.4±5.1岁,用免疫浊度法测定C反应蛋白(CRP)浓度,应用B型超声检测颈动脉内膜中层厚度(IMT)及粥样斑块,然后分析C反应蛋白浓度变化与高血压病患者收缩压及舒张压的关系,C反应蛋白浓度与颈动脉内膜中层厚度(IMT)的关系。结果高血压病组CRP浓度、颈动脉内中膜厚度显著高于正常对照组,随着颈动脉内中膜增厚,C反应蛋白亦增高,各组之间差异均有显著性(P≤0.01)。结论高血压病患者血清C反应蛋白浓度增高与颈动脉内中膜厚度关系密切;C反应蛋白浓度与颈动脉内中膜厚度两者之间存在一定的相关性;高血压级别越高,IMT及CRP浓度越大,不同级别间的差异有显著性(P<0.05),C反应蛋白如同TC、TG、IMT一样与高血压患者中的动脉粥样硬化程度有关,C反应蛋白浓度随着高血压级别增大有增高的趋势,炎症反应可能参与了高血压病的发生、发展;降低C反应蛋白浓度,抑制炎症反应可能阻止动脉粥样硬化进展。

Objective： To explore the relationship between the carotid Intima-media thickness and C-reactive protein in patients with essential hypertension. Methods： 105 patients with hypertension were selected, including 55 males and 50 females [mean age（57.8± 5.2）years], 65 healhy persons in physical examinations was selected as contrast, including 36 males and 29 females [ mean age （56.4 ± 5.1 ）years]. C-reactive protein （CRP） was determined by immunology method. B-mode ultrasound was used to scan carotid arteries of all the cases and the contrasts in order to check and measure intimamedia thickness （IMT） and plaques of carotid arteries. The relations between concentration in hypertensive patientsof C - reactive protein with systolic and diastolic blood pressure, and between the C -reactive protein concentration and carotid IMT （IMT） were analyzed. Results： The concentrations of CRP and IMT were higher in the essential hypertension groups than those in the contrast group （ P ≤0. 01 ）. Positive correlation was found between concentrations of CRP and IMT. Conclusion ： The increased concentrations of serum CRP were closely correlated with increased carotid intima-media thickness in patients with hypertension. CRP, like TC, TG and IMT, was related with the degree of atherosclerosis. Inflammation is probably involved in the course of hypertension. Decrease in the concentrations of serum CRP and the control of inflammation can prevent the development of atherosclerosis.