老年高血压患者炎症因子变化与颈动脉粥样硬化的相关性

Correlation of inflammatory factors with carotid atherosclerosis in elderly hypertensive patients

目的探讨老年高血压患者颈动脉粥样硬化与炎症因子的关系。方法选取老年原发性高血压患者48例,健康体检者30例,应用彩色多普勒超声检测颈动脉内膜中层厚度(intima-media thickness,IMT),以颈动脉超声IMT≥0.9 mm作为颈动脉内膜增厚或动脉粥样斑块指标。测定C反应蛋白(CRP)、IL-6、TNF-α及血脂、血糖、血压等。结果老年高血压组收缩压、舒张压、TC、LDL-C及颈动脉斑块发生率明显高于对照(P<0.01)。老年高血压组CRP、IL-6、TNF-α、颈动脉IMT值均明显高于对照组(P<0.01)。在老年高血压患者,颈动脉IMT与CRP(r=0.422;P<0.01)、IL-6(r=0.313;P<0.01)、TNF-α(r=0.296;P<0.01)进行直线相关分析,结果显示IMT与炎症因子呈正相关。结论老年高血压患者颈动脉粥样硬化的形成除与血压增高、血脂异常有关外,炎症因子是其发病的主要因素。

Objective To investigate the correlation of inflammatory factors with carotid atherosclerosis in elderly hypertensive patients. Methods Forty eight elderly patients with essential hypertension and 30 healthy subjects （controls） underwent color Doppler ultrasonography for carotid intima-media thickness （IMT）. On ultrasonography the IMT carotid ≥ 0.9 mm was used as index for carotid artery intimal thickening or atherosclerotic plaque. Serum C-reactive protein （CRP）, interleukin 6 （IL-6）, tumor necrosis factor-alpha （TNF-ct） and blood lipids, blood glucose and blood pressure were measured. Results The systolic blood pressure, diastolic blood pressure, TC, LDL-C and carotid artery plaque in hypertensive patients were significantly higher than those in controls （P 〈 0.01 ）. Serum CRP, IL-6 and TNF-a, the value of carotid IMT were significantly higher in elderly hypertensive group than those in control group （ P 〈 0.01 ）. Linear regression analysis showed that carotid IMT was significantly correlated with CRP （ r =0. 422 ;P 〈0.01 ）, IL-6 （ r =0. 313 ;P 〈0.01 ） and TNF-a （ r = 0. 296 ; P 〈 0.01 ） in elderly hypertensive patients. Conclusion Besides elevated blood pressure and dyslipidemia, inflammatory factors may be the main risk factors for carotid atherosclerosis in elderly hypertensive patients.