高血压合并急性脑梗死患者血清视黄醇结合蛋白4与血压变异性的关系

Relationship between Serum Retinol Binding Protein 4 and Blood Pressure Variability in Hypertension Complicated with Acute Cerebral Infarction

目的探讨高血压合并急性脑梗死患者血清视黄醇结合蛋白4(RBP4)与其血压变异性的关系,以及可能的作用机制。方法选择78例高血压病合并急性脑梗死患者为观察组,以同期住院或门诊就诊且年龄、性别组成相匹配的45例单纯性高血压病患者为对照组。所有患者均行24h动态血压监测,采取静脉血作常规血生化检查,用酶联免疫法测定血清RBP4水平,统计患者临床资料。用Pearson线性相关分析RBP4与血压变异性以及临床资料、血生化指标的相关性。结果观察组血清RBP4水平、24h收缩压标准差(24SSD)、白昼收缩压标准差(dSSD)、夜间收缩压标准差(nSSD)、胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.01)。血清RBP4与HOMA-IR(r=0.443,P<0.01)、24SSD(r=0.419,P<0.01)、dSSD(r=0.432,P<0.01)、nSSD(r=0.372,P<0.05)呈显著正相关。结论视黄醇结合蛋白4可能通过增加胰岛素抵抗,加大高血压病患者收缩压的变异性,促进脑梗死的发生或发展。

Objective To investigate relationship between serum retinol binding protein 4 （RBP4） and blood pressure variability in hypertension patients （pts） complicated with acute cerebral infarction. Methods Seventy - eight patients with acute hypertension complicated with cerebral infarction were as observation group,and 45 cases with hypertension were as control group. The 24- hour ambulatory blood pressure monitoring was performed in all pts. Blood biochemistry was examined, and levels of serum RBP4 was tested using enzyme immunoassay method. The relation between RBP4 and blood pressure variability, clinical data, and blood bio- chemical index were analyzed by Pearson linear correlation analysis. Results The serum RBP4 levels,24 hour systolic blood pressure （24SSD） ,the standard deviation of the systolic pressure standard deviation （dSSD）,nocturnal systolic blood pressure standard deviation （nSSD） ,insulin resistance index （HOMAIR） in observation group were higher than those in the control group （P〈0.01）. The serum RBP4 and HOMAIR （r=0.443, P〈0.01）, 24SSD （r=0.419, P〈0.01）,dSSD （r=0.432,P〈0.01）,nSSD（r=0.372, P〈0.05） were related positively. Conclusion The RBP4 might promote occurrence of cerebral infarction or development by increasing insulin resistance and systolic blood pressure variability in patients with essential hypertension.