原发性高血压患者血压变异性和血清高敏C反应蛋白及基质金属蛋白酶-9关系的研究

Relationship between blood pressure variability and serum high sensitive C-reactive protein and matrix metalloproteinase-9 in patients with essential hypertension

目的研究原发性高血压(EH)患者血压变异性(BPV)与高敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)之间的关系。方法收集符合纳入标准的患者资料,分为高血压组(n=117例)和正常血压对照组(n=32例)。对入选的117例EH患者行24 h动态血压监测(ABPM),根据24 h收缩压变异性(24hSBPV)第50百分位数(P50)将其分为高BPV组(57例)和低BPV(60例)组。所有患者均采用胶乳比浊法测定hs-CRP,ELISA法测定MMP-9,比较各组hs-CRP和MMP-9水平。结果 EH组24 h SBPV高于对照组(P<0.01),hs-CRP和MMP-9较血压正常组也显著升高(P<0.01)。EH组中,高BPV组患者hs-CRP和MMP-9显著升高(P<0.01)。24 h SBPV与年龄、高血压病程、LDL-C、hs-CRP及MMP-9呈正相关;多元线性回归显示,hs-CRP、MMP-9、LDL-C进入回归方程。结论 EH患者BPV可能与hs-CRP及MMP-9相关。

Objective To study the relationship between blood pressure variability（BPV） and serum high sensitive C-reactive protein（hs-CRP） and matrix metalloproteinase-9（MMP-9） in patients with essential hypertension.Methods A total of 149 patients were included in the study.The participants were divided into two groups： those with hypertension（n=117） and those without hypertension（n=32）.According to the results of 24 h ambulatory blood pressure monitoring for the selected 117 cases with essential hypertension,the patients with hypertension were divided into low and high variability groups according to the 50 th percentile of 24 h SBPV.Hs-CRP was measured with turbidimetry and MMP-9 with enzyme linked immunosorbent assay（ELISA） in the total patients.Results The patients with essential hypertension had significantly higher 24 h SBPV（P0.01） than those without hypertension.Serum hs-CRP and MMP-9 also were significantly higher in the patients with hypertension than those without hypertension（P0.01）.Compared with the patients with lower BPV,the serum hs-CRP and MMP-9 increased significantly in the patients with higher BPV（P0.01）.Pearson relation analysis showed that 24 h SBPV level had significant positive correlation with age,course of disease,LDL-C,hs-CRP and MMP-9 in patients with hypertension.Multivariate regression analysis showed that the LDL-C,hs-CRP,MMP-9 were predictors of 24 hSBPV levels.Conclusion The BPV is related to hs-CRP and MMP-9 in patients with essential hypertension.