高血压病合并脑梗死患者脉搏波传导速度及血清晚期糖基化终产物的变化特点

A study on pulse wave velocity and advanced glycation end products in patients with hypertension complicated with cerebral infarction

目的 探讨脉搏波传导速度（PWV）及血清晚期糖基化终产物（AGEs）在高血压病并发脑梗死过程中的作用.方法 选择2009年1月至2010年12月我院门诊未服用降压药物或停药2周以上的高血压病患者150例（A组）、高血压病合并脑梗死患者150例（B组）,健康人群50例作为正常对照组（C组）.应用自动PWV分析仪测定颈-股动脉脉搏波传导速度（CFPWV）和颈-桡动脉脉搏波传导速度（CRPWV）,采用酶联免疫吸附试验测定血清中AGEs浓度.结果 与A组的CFPWV[（12.76±1.25）m/s]、CRPWV[（10.79±0.95）m/s]及AGEs[（187.42±35.72）mg/L]相比,B组的CFPWV[（15.73±2.17）m/s]、CRPWV[（13.87±1.86）m/s]及AGEs[（286.53±43.29）mg/L]均明显增高;随着CFPWV、CRPWV及AGEs增高,高血压并发脑梗死危险性明显增加（P=0.015,P=0.008,P=0.027）;二分类Logistic回归分析以脑梗死为因变量,以年龄、SBP、DBP、CFPWV、CRPWV和AGEs为自变量,发现CFPWV、CRPWV及AGEs为高血压并发脑梗死的独立危险因素,OR、95%CI及P值分别为3.95、2.37～8.19、0.019;4.28、1.53～7.62、0.032;3.87、2.57～8.39、0.019.结论 PWV增快及血清中AGEs浓度增高是高血压病患者并发脑梗死的独立危险因素.

Objective To investigate the effects of pulse wave velocity（PWV） and advanced glycation end products（AGEs） on hypertension complicated with cerebral infarction. Methods Overall 350 subjects were enrolled in this study： 150 patients with primary hypertension without cerebral infarction, 150 patients with primary hypertension complicated with cerebral infarction and 50 aged-matched normotension control （NT） subjects. All of them were detected pulse wave velocity（CFPWV, CRPWV） and the serum concentration of AGEs. Results Compared with primary hypertension without cerebral infarction patients, the CFPWV, CRPWV and AGEs of the patients with primary hypertension complicated with cerebral infarction were significantly higher [CFPWV（12.76±1.25）m/s vs （15.73 ±2.17）m/s], CRPWV（10.79 ±0.95）m/s vs（13.87 ±1.86）m/s and [AGEs（187.42±35.72）mg/L vs （286.53 ±43.29）mg/L]. Furthermore, with the increase of CFPWV, CRPWV and AGEs, the morbidity of primary hypertension complicated cerebral infarction were markedly increased（P=0.015, P = 0.008, P = 0. 027）. Logistic analysis showed that CFPWV, CRPWV and AGEs were independently correlated with primary hypertension complicated cerebral infarction respectively. Conclusion The increasing of PWV and AGEs might be involved in the development of primary hypertension complicated with cerebral infarction.