晚期糖基化终末产物与老年高血压病颈动脉粥样硬化关系的研究

Correlation between Advanced Glycosylation End Products and Carotid Atherosclerosis in Elderly Patients with Essential Hypertension

目的探讨晚期糖基化终末产物(AGEs)与老年高血压病(EH)患者颈动脉粥样硬化的相关性。方法采用酶联免疫吸附分析方法(ELISA法)测定125例老年EH患者及70例健康老年人血清AGEs浓度,同时测量血压,并使用B型动脉超声测定颈动脉内中膜厚度(IMT)及斑块,根据IMT将EH患者分为非IMT增厚组(40例)和IMT增厚组(85例),根据斑块严重程度EH患者分为0～3级4组。结合AGEs、IMT对各组进行比较和综合分析。结果EH两组患者血清AGEs均显著高于健康老年人(均P<0.01),非IMT增厚组与IMT增厚组比较差异亦有统计学意义(P<0.01),血清AGEs水平随着斑块严重程度的加重而升高,斑块分级4组之间AGEs水平组间比较差异有统计学意义(P<0.05),并且IMT与AGEs及脉压(PP)呈显著正相关,IMT增厚组相关系数分别为0.742和0.638(均P<0.05),非IMT增厚组相关系数分别为0.553和0.425(均P<0.05),所有患者相关系数分别为0.679和0.538(均P<0.05)。进行逐步回归分析,结果显示,AGEs、PP与IMT增厚密切相关。结论血清AGEs水平升高与老年EH患者动脉硬化发病密切相关。

Objective To observe the relationship between advanced glycosylation end products （AGEs） and carotid athemsclemsis in elderly patients with essential hypertension （EH）. Methods One hundred and twenty-five elderly EH patients and 70 healthy old people were selected. AGEs were determined by ELISA, blood pressure was measured, and carotid intima-media thickness （IMT） and the plaque of carotid artery were observed by B ultrasound. The patients were divided into two groups according to the IMT. All patients were divided into 4 groups of 0--3 grades according to the plaque. The AGEs and IMT in all groups were analyzed and compared. Results Serum AGEs levels in EH patients were significantly higher than the healthy old people （all P〈0.01）, and there was significant difference between IMT non-thickened group and IMT thickened group （P〈 0.01）. The serum AGEs levels were increased with the severity of plaque. There was significant difference in serum AGEs levels among 4 groups based on plaque grades （P〈0.05）. IMT was positively correlated with AGEs, and PP in IMT thickened group with the correlation coefficient being 0. 742 and 0. 638 （both P〈0.05）, that in IMT non-thickened being 0. 553 and 0. 425 （both P〈0.05）, and that in all patients being 0. 679 and 0. 538 respectively （both P〈0.05）. The multiple regression analysis revealed that AGEs, and PP were closely related with IMT thickening. Conclusion The serum AGEs levels were closely correlated with atherosclerosis in elderly EH patients.