原发性高血压患者血清高敏C反应蛋白、抵抗素与颈总动脉内中膜厚度的临床研究

Clinical research on serum hsCRP,resistin and IMT in essential hypertension

目的观察原发性高血压患者血清高敏C反应蛋白(hsCRP)、抵抗素(Resistin)与颈总动脉内中膜厚度(IMT)的关系。方法选用原发性高血压患者103例为病例组,正常健康查体者43例为对照组,病例组根据血压的不同分为3个亚组:1级28例、2级33例、3级42例。所有受试者均进行血压测量,检测颈总动脉IMT,应用酶联免疫吸附测定(ELISA)法检测血清hsCRP、Resistin。结果原发性高血压患者IMT、hsCRP、Resistin显著高于正常对照组(均P<0.01),其中位数和四分位数间距分别为IMT[3.00(2.00)]分vs[0.00(1.00)]分、hsCRP[4.51(4.36)]mg/L vs[2.01(0.95)]mg/L、Resistin[2.87(1.99)]μg/L vs[1.59(1.46)]μg/L。随着血压级别的上升IMT、hsCRP、Resistin有逐渐升高的趋势(P<0.05)。2级和3级高血压的IMT高于1级高血压(P<0.01);3级高血压的hsCRP、Resistin高于1级和2级高血压(P<0.05),分别为IMT 1级[1.00(2.00)]分vs 2级[3.00(2.00)]分vs 3级[3.00(2.00)]分、hsCRP 1级[3.61(2.35)]mg/L vs 2级[6.00(5.69)]mg/L vs 3级[4.45(4.88)]mg/L、Resistin1级[2.01(1.49)]μg/L vs 2级[3.11(2.27)]μg/L vs 3级[3.11(1.28)]μg/L。高血压组IMT、hsCRP、Resistin相关分析,IMT与hsCRP、Resistin均呈正相关(r=0.500、0.490,均P<0.01),Resistin与hsCRP呈正相关(r=0.396,P<0.01)。结论原发性高血压患者IMT、hsCRP、Resistin水平均明显高于健康人群。与经典的炎症因子hsCRP比较,Resistin对原发性高血压患者动脉粥样硬化的形成更值得关注。

Objective To investigate the correlation between high sensitive C-reactive protein（hsCRP）,resistin and intima-media thickness（IMT） of carotid artery in essential hypertension（EH）. Methods The experimental group included 103 cases from consecutive patients diagnosed as EH. The control group included 43 cases from those who accepted physical examination in the same setting. The experimental group was divided into three subgroups according to the grades of blood pressure. Blood pressure was measured, carotid artery, IMT, features, number of plaques were detected,ELISA was used to detect hsCRP, resistin in the supernate. Results IMT, hsCRP, resistin in EH group differed from those in the control group significantly （P 〈0.01 ）. IMT 3.00 （2.00） scores vs 0.00 （1.00） scores, hsCRP 4.51（4.36） mg/L vs 2.01（0.95） mg/L,Resistin 2.87（1.99） μg/L vs 1.59（1.46）μg/L. IMT,hsCRP,resistin elevated gradually with the upgrade of EH（ P 〈0.05）. IMT in the grade 2 and 3 was higher than in the grade 1 ;serum hsCRP,resistin in the grade 3 was higher than in the grade 1 and 2（ P d0.05） ,for IMT grade 1 [1.00（2.00）] scores vs grade 2 [3.00（2.00）] scores vs grade 3 [3.00（2.00）] scores, for serum hsCRP grade 1 [3.61 （2.35）] mg/L vs grade 2 [6.00（5.69）7 mg/L vs grade a[4. 45（4. 88）] mg/L,for serum resistin grade 1 [2.01（1.49）1 μg/L Vs grade 2 [3.11（2.27）] 〉g/L vs grade 3 [3.11（1.28）] μg/L. IMT and serum hsCRP（ r=0.500）,resistin（r=0.490, P〈 0.01） correlated positively in the experimental group. There was also positive linear correlation between resistin and hsCRP（ r =0. 396, P 〈0.01）. Conclusion IMT,hsCRP,resistin in EH were obviously higher than in the health. As compared with hsCRP,the classic inflammatory factor,the effect of resistin on AS is worth attentioning.