摘要
目的探讨血清脂联素在原发性高血压(EH)发病中的作用及与颈动脉内膜中层厚度(IMT)的关系。方法60例EH患者(EH组)和30例健康体检者(对照组)为研究对象,60例EH组患者根据《中国高血压防治指南(2005年)》中血压的分级标准分为三个亚组,1级EH组、2级EH组、3级EH组,每组20例。采用双抗体夹心ABC-酶联免疫吸附试验(ELISA)法检测血清脂联素水平,采用全自动生化仪测定血脂水平,采用彩色多普勒超声仪测定颈动脉IMT。结果与对照组比较,EH组及1、2、3级EH组血清脂联素水平降低[(3.94±1.28)、(5.25±1.69)、(4.01±1.27)、(2.56±0.87)mg/L比(7.63±2.50)mg/L],颈动脉IMT增加[(1.30±0.42)、(0.94±0.30)、(1.32±0.44)、(1.65±0.51)mm比(0.69±0.22)mm],差异均有统计学意义(P〈0.05);且EH各亚组间两两比较,随着血压水平升高,血清脂联素水平逐渐降低,颈动脉IMT逐渐增加,差异均有统计学意义(P〈0.05)。与对照组比较,EH组及1、2、3级EH组血清TC、TG、LDL-C水平上升[TC:(6.53±2.09)、(5.14±1.66)、(6.59±2.20)、(7.86±2.42)mmol/L比(4.17±1.32)mmol/L;TG:(2.15±0.69)、(1.72±0.55)、(2.07±0.69)、(2.65±0.82)mmol/L比(1.38±0.44)mmol/L;LDL-C:(3.78.±1.21)、(3.12±1.01)、(3.74±1.25)、(4.48±1.38)mmol/L比(2.46±0.78)mmol/L],HDL-C水平下降[(0.96±0.31)、(1.39±0.45)、(0.85±0.28)、(0.64±0.20)mmol/L比(1.69±0.54)mmol/L],差异均有统计学意义(P〈0.05);且EH各亚组间两两比较,随着血压水平升高,血清TC、TG、LDL-C水平上升,HDL-C水平下降,差异均有统计学意义(P〈0.05)。血清脂联素水平与颈动脉IMT呈显著负相关(r=-0.435,P〈0.01),与血脂(TC、TG、LDL-C、HDL-C)水平有相关性(P〈0.01)。结论脂联素在EH的发生和发展过程中起着重要作用,并与颈动脉IMT的增厚和血脂代谢紊乱密切相关,顽固性EH患者增加降血脂药物可能会提高降血压治疗的疗效。
Objective To investigate the changes of serum adiponectin (APN) levels in patients with essential hypertension (EH) and the correlation with carotid artery intima-media thickness (IMT). Methods Sixty patients with EH(EH group) and 30 healthy people (control group) were studied,the EH patients were divided into 3 subgroups with 20 cases each according to the standard of China guideline for hypertension prevention and control (2005). The serum APN level was detected by double antibody sandwich ABC enzyme-linked immunosorbent assay,the blood lipids levels [total cholesterol (TC), triglyeride (TG),low density lipoprotein-cholesterol (LDL-C) and highdensity lipoprotein-cholesterol (HDL-C) ] were detected by automatic biochemical analyzer, and the carotid artery IMT was detected by color Doppler ultrasonography. Results The serum APN levels and carotid artery IMT in EH group and 1,2,3 subgroup were significant differences compared with those in control group [ (3.94 ± 1.28), (5.25 ± 1.69), (4.01 ± 1.27), (2.56 ± 0.87) mg/L vs. (7.63 ± 2.50) mg/L; ( 1.30 ± 0.42), (0.94 ± 0.30), ( 1.32 ± 0.44), ( 1.65 ± 0.51 ) mm vs. (0.69 ± 0.22) mm,P 〈 0.05]. The comparison between two subgroups,along with elevated blood pressure levels,APN levels gradually decreased,and carotid artery IMT gradually increased (P 〈 0.05). The serum TC,TG,LDL-C and HDL-C levels in EH group and 1,2,3 subgroup were significant differences compared with those in control group [TC : (6.53 ± 2.09), (5.14 ± 1.66), (6.59 ± 2.20), (7.86 ± 2.42) mmol/L vs. (4.17 ± 1.32) mmol/L;TG: (2.15 ± 0.69), (1.72 ± 0.55), (2.07 ± 0.69), (2.65 ± 0.82) mmol/L vs. (1.38 ±0.44) mmol/L;LDL-C: (3.78 ± 1.21), (3.12 ± 1.01), (3.74 ± 1.25), (4.48 ± 1.38) mmol/L vs. (2.46 ± 0.78) mmol/L;HDL-C : (0.96 ± 0.31 ), ( 1.39 ± 0.45 ), (0.85 ± 0.28), (0.64 ± 0.20) mmol/L vs. ( 1.69 ± 0.54 ) mmol/L, P 〈 0.05 ]. The comparison between two subgroups, along with elevated blood pressure levels, TC, TG and LDL-C levels gradually increased, and HDL-C gradually decreased (P 〈 0.05 ). There was negative correlation between the serum APN level and carotid artery IMT (r = -0.435 ,P 〈 0.01 ), and there was correlation between the serum APN level and blood lipids levels (TC ,TG, LDL-C and HDL-C ) (P 〈 0.01 ). Conclusions The APN plays an important role in the occurrence and development of EH,it is closely related to the carotid artery IMT thickening and lipid metabolism disorders. Increasing the lipid-lowering drugs may improve the efficacy of antihypertensive therapy in patients with resistant EH.
出处
《中国医师进修杂志》
2012年第36期16-19,共4页
Chinese Journal of Postgraduates of Medicine
关键词
高血压
脂联素
颈动脉
内膜中层厚度
Hypertension
Adiponectin
Carotid arteries
Intima-media thickness