原发性高血压患者CD36与其他危险因子的关系

Changes of CD36,Inflammatory Cytokines in Patients with Essential Hypertension

背景外周血淋巴细胞CD36是一种血液黏附因子,广泛分布于不同细胞表面,在高血压、糖尿病等血管病变发展中起一定作用。目的探讨原发性高血压(EH)患者外周血单核细胞CD36表达水平与血压、炎症和血管内皮功能的关系。方法入选40例新发EH患者和30例血压正常者,检测受试者外周血单核细胞CD36、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、血管性假血友病因子(vWF)和NO的水平。比较两组CD36、炎症因子和血管内皮功能循环生物标记物水平的差异;用多重线性回归筛选平均动脉压的影响因素。结果①EH患者外周血单核细胞CD36的阳性率较对照组增高[CD36,EH组(74.6±7.9)%比对照组(55.2±7.0)%,P<0.01];②EH患者血清炎症因子TNF-α和IL-6的水平显著高于对照组[TNF-α,EH组(60.5±9.2)比对照组(35.5±9.1)ng/L;IL-6,高血压组(11.5±3.0)比对照组(4.9±1.5)ng/L,均P<0.01];③EH患者血管内皮功能循环生物标记物vWF较对照组增高,NO水平较对照组降低[vWF,EH组(141.9±18.1)%比对照组(107.8±15.2)%;NO,EH组(51.1±9.0)比对照组(76.6±11.9)μmol/L,均P<0.01];④相关分析显示CD36与TNF-α、IL-6和vWF呈正相关,与NO呈负相关(均P<0.01);⑤多重线性回归显示CD36、NO和IL-6是平均动脉压的影响因素(均P<0.01)。结论EH患者外周血单核细胞CD36和炎症因子表达水平增高,内皮功能受损;CD36、NO和IL-6是平均动脉压的影响因素。

Background CD36 is a kind of adherence factor involved in the vascular injuries in hypertension and diabetes. Objective To investigate the relation between CD36, inflammatory cytokines and endothelial function in patients with essential hypertension （EH）. Methods Forty hypertensives and 30 normotensives were enrolled into this study. CD36 level of monocyte, concentrations of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, yon Willebrand factor （vWF） and nitric oxide （NO） were measured. Results ①CD36 level of monocyte in hypertension group was increased as compared with that in control group [CD36, EH group： （74.6 ± 7.9） % vs control group： （55.2±7.0） %, P〈0.01,]. ②Serum concentrations of TNF-α and IL-6 in EH group were increased as compared with that in control group [TNF-α, EH group （ 60.5 ± 9.2） vs control group （35.5 ± 9.1 ） ng/L; IL-6, EH group （11.5±3.0） vs control group （4.9±1.5）ng/L, P〈0.01, respectively]. ③Serum levels of vWF was statistically higher and NO was lower in hypertension group than those in control group [vWF, EH group （141.9±18. 1）% vs control group （107.8±15. 2） %; NO, EH group （51.1±9. 0） vs control group （76.6±11.9）μmol/L, P〈0.01, respectively]. ④Pearson correlation analysis revealed that CD36 was positively correlated with TNF-α, IL-6 and vWF, negatively correlated with NO （P〈 0.01, respectively）. ⑤Multiple linear regression analysis showed that CD36, NO and IL-6 were predisposing risk factors for MAP （P〈0.01）. Conclusion CD36 level of monocyte, serum concentrations of inflammatory cytokines were increased, and endothelial function were damaged in patients with EH. CD36, NO and IL-6 were risk factors associated with MAP.