老年高血压患者血浆总抗氧化能力水平变化及临床价值

Change of total antioxidant capacity with essential hypertension in elderly patients and its clinical usefulness

目的 研究老年原发性高麻压患者血浆总抗氧化能力 （total antioxidant capacity,TAS） 水平变化;分析 TAS相关因素;探讨老年高血压患者TAS检测的临床价值.方法 选取上海交通大学附属仁济医院老年病科住院男性患者100 例,年龄69～92岁,平均 （83.3±6.2） 岁,分为非高血压组 （n=37） 和高血压组 （n=63）,通过化学发光定量法榆测其血浆TAS,同时测定超敏C反应蛋白（high-sensitivity C-reaction protein,hsCRP）、尿微量白蛋白 （MAU）、血脂、血尿酸、转铁蛋白等,并利用彩色多普勒超声测定颈动脉内膜厚度 （CIMT）.结果 高血压组患者 TAS 值低于对照组（分别为1.068±0.058 mmol/L与1.094±0.048 mmol/L,P=0.045）.单变量分析显示：TAS 与尿微量白蛋白 （r=-0.311,P=0.014）、血尿酸 （r=-0.399.P=0.001）,超敏CRP （hsCRP） （r=-0.269,P=0.011） 呈负相关;校年龄以后作偏相关分析提示TAS与hsCRP （r=-0.334,P=0.02） 呈负相关.结论老年高血压患者存在TAS降低,且与超敏CRP有一定相关性,通过TAS来评估老年原发性高血压炎症反应和抗氧化状态具有一定的临床价值.

Objective To investigate the clinical significance of plasma total antioxidant capacity （TAS） levels in the elderly with essential hypertension （EH）, and to dertermine it＇s correlation factors. Methods 66 elderly patients with essential hypertension were selected, and another 37 elderly non-EH people as control. All elderly patients underwent examination of plasma TAS, high-sensitivity C-reaction protein （hsCRP）, urine microalbumin, uric acid, transferring and carotid intima-media thickness were performed by corlor Doppler ultrasonography. Results Plasma levels of TAS in the patients with EH were significantly lower than the control group. In univariate analysis, there was a negative relationship between TAS and urine microalbumin （r=-0.311, P=0.014）, uric acid （r=-0.399, P=0.001）, hsCRP （r=-0.269, P=0.011）. By revising thefactor of age, TAS was still negatively correlated with hsCRP （r=-0.334, P=0.02）. Conclusions Plasma levels of TAS are lower in patients with EH in the elderly and there is correlation between TAS and hsCRP. TAS as a useful clinical approach can be used to evaluate the inflammatory response and antioxidation in elderly people with essential hypertension.