新疆哈萨克族高血压患者血浆妊娠相关蛋白A水平变化及临床意义

Changes and clinical significance of pregnancy-associated plasma protein A levels in patients with essential hypertension in Xinjiang Kazakhs

目的探讨新疆哈萨克族(哈族)原发性高血压(EH)患者妊娠相关蛋白A(PAPP-A)水平及其与血压、血脂、血糖的关系。方法选择新疆哈族EH患者80例(EH组),哈族健康人群30例(对照组)。EH组根据血压水平分为:EH 1级15例,EH 2级30例,EH 3级35例。采用酶联免疫吸附法测定血浆PAPP-A水平。结果哈族各级EH血浆PAPP-A水平显著高于对照组,EH 1级(4.97±0.80)mg/L、EH 2级(5.99±0.86)mg/L、EH 3级(6.54±0.94)mg/L vs对照组(3.90±0.64)mg/L(P<0.01)。EH 2级组PAPP-A水平明显高于EH 1级组(P<0.01),EH 3级组PAPP-A水平显著高于EH 2级组(P<0.01)。哈族EH组血浆PAPP-A与收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)呈显著正相关(rs=0.540、0.442、0.296,P<0.05)。对照组PAPP-A与上述指标无相关性(P>0.05)。多元回归分析显示:在哈族EH组中,SBP和TC是影响PAPP-A的独立危险因素;对照组中,上述各指标均不是影响血浆PAPP-A水平的独立因素。结论哈族EH患者血浆PAPP-A水平升高并与血压之间存在一定的相关性。

Objective To explore the plasma pregnancy-associated plasma protein A（PAPP-A） level in the Kazakhs patients with essential hypertension（EH） and relationship between plasma PAPP-A level and blood pressure,blood glucose,blood lipids.Methods Eighty Kazaks patients with EH were analyzed as EH group and 30 healthy subjects served as control group.The EH group was allocated to group 1（n=15）,group 2（n=30）,group 3（n=35） by the grade of blood pressure.The plasma PAPP-A was detected by ELISA.Results PAPP-A level in EH group was significantly higher than that in control group,the grade 1 group（4.97±0.80） mg/L,the grade 2 group（5.99±0.86）mg/L,the grade 3 group（6.54±0.94） mg/L vs control group（3.90±0.64） mg/L（P0.01）.Compared with grade 1 group,the concentration of PAPP-A in grade 2 group was markedly increased（P0.01）,and the level of PAPP-A in grade 3 group was significantly higher than that in grade 2（P0.01）.In EH group,PAPP-A was positively correlated with SBP,DBP,TC（r_s=0.540,0.442,0.296,P0.05）,but PAPP-A correlated with none in control（P0.05）.Multiple regression analysis showed that SBP and TC were independent factors to affect the PAPP-A level in EH group,none was independent factors to affect the plasma PAPP-A level in control group.Conclusion The plasma PAPP-A level is increased in Kazaks patients with EH,and there is correlation beween PAPP-A and blood pressure.