中青年原发性高血压患者循环内皮祖细胞CD34＋水平与颈动脉粥样硬化的相关性研究

The relationship between the level of circulating endothelial progenitor cells CD34＋ and carotid artery arteriosclerosis in youth and middle aged patients with essential hypertension

目的 探讨中青年原发性高血压患者循环内皮祖细胞（EPCs）CD34＋水平与颈动脉内膜中层厚度（IMT）和Framingham心血管危险因素积分标准（FRFC）的相关性及其评估高血压患者早期血管病变的价值.方法选择62例年龄25～45岁原发性高血压患者（高血压组）及20例健康体检者（健康对照组）.高血压组患者采用FRFC分层方法分为低危组18例,中危组14例,高危组17例,极高危组13例.测定各组的外周循环EPCs CD34＋水平及颈动脉IMT,并对EPCs CD34＋水平与FRFC积分及颈动脉IMT进行相关性分析.结果 高血压各亚组患者外周循环EPCs CD34＋水平随心血管危险程度的增加逐步下降[低危组（0.12±0.02）%,中危组（0.07±0.03）%,高危组（0.04±0.03）%,极高危组（0.01±0.01）%],各组间比较差异有统计学意义（P＜0.05或P＜0.01）,且均明显低于健康对照组[（0.15±0.03）%,均P＜0.01];颈动脉IMT随心血管危险程度增加明显增厚[低危组（0.80±0.07）mm,中危组（1.11±0.08）mm,高危组（1.26±0.10）mm,极高危组（1.45±0.09）mm],各组间比较差异有统计学意义（P＜0.05或P＜0.01）,且与健康对照组[（0.73±0.08）mm]比较差异有统计学意义（均P＜0.01）.高血压患者外周循环EPCs CD34＋水平与FRFC积分呈负相关（r=-0.875,P＜0.01）,与颈动脉IMT呈负相关（r=-0.852,P＜0.01）.结论 中青年原发性高血压患者循环EPCs CD34＋水平与心血管危险因素及颈动脉IMT呈负相关;外周循环EPCs CD34＋水平可以作为评估高血压患者早期血管病变的标志之一.

Objective To explore the relationship between the level of circulating endothelial progenitor cells （EPCs） CD34＋with the Framingham cardiovascular risk factors, or with the carotid artery intima-madia thickness （IMT）, and to evaluate the value of circulating EPCs CD34＋level as a cytologicalmarker of early vascular lesion in youth and middle aged essential hypertension （EH） patients.Methods A total of 62 patients with EH aged between 25 to 45 were enrolled as study group and 20 healthy people were enrolled as control group.EH patients were stratified with cardiovascular risk factors according to Framingham risk factors score into low-risk group with 18 cases, mid-risk group with 14 cases, high-risk group with 17 cases, and extremely high-risk group with 13 cases.The level of circulating EPCs CD34＋,carotid artery IMT were respectively measured.The relationship between the level of circulating EPCsCD34＋ and Framingham cardiovascular risk factors score, carotid artery IMT was analyzed.Results The level of circulating EPCs CD34＋ was gradually decreased with an increase of the Framingham risk factors score in each hypertensive subgroup [low-risk group：（0.12±0.02）%, mid-risk group：（0.07±0.03）%,high-risk group：（0.04±0.03）%, extremely high-risk group：（0.01±0.01）%], and they were significantly lower than that in control group [（0.15±0.03）%], and there was a significant difference among hypertensive subgroups （P〈0.05 or P〈0.01）.Carotid artery IMT was significantly thicker among hypertensive subgroups [low-risk group：（0.80±0.07）mm, mid-risk group：（1.11±0.08）mm, high-risk group： （1.26±0.10）mm, extremely high-risk group：（1.45±0.09）mm], and there was a significant difference between each hypertensive group and that of control group [（0.73±0.08）mm, all P〈0.01].There was also statistical significance among hypertensive subgroups（P〈0.05 or P〈0.01）.There was a negative correlation between the level of circulating EPCs CD34＋and Framingham risk factors score （r=-0.875, P〈0.01）, and also a negative correlation with carotid artery IMT （r=-0.852, P〈0.01）.Conclusion There was a significant correlation between the level of circulating EPCs CD34＋with Framingham risk factors score and also carotid artery IMT in EH patients.Circulating EPCs CD34＋could be a cytological marker of early vascular lesion in hypertension patients.