胱抑素C、核因子-κB与老年高血压患者血管重构的相关性研究

Correlation of Serum Cystatin C and Nuclear Factor-κB with Vascular Remodeling in Elderly Patients with Hypertension

目的探讨胱抑素C(Cys-C)、核因子-κB(NF-κB)在老年高血压患者颈动脉及肱动脉重构中的意义。方法免疫比浊法测定42例老年高血压肾功能正常者,48例老年高血压肾功能异常者及46名正常对照者血清Cys-C的浓度。免疫组化方法检测核因子NF-κB活化表达率,血管超声检测颈动脉、肱动脉血管重构超声指标。结果高血压组Cys-C、NF-κB水平明显高于正常对照组,与外周血单个核细胞NF-κB活化率呈显著正相关(r=0.657,P<0.01)。血清Cys-C水平与内生肌酐清除率呈显著负相关(r=-0.577,P<0.01)。Cys-C、NF-κB水平与颈总动脉内径,颈动脉、肱动脉内膜-中层厚度,颈动脉斑块积分,血管搏动指数、阻力指数等反映血管重构的指标呈正相关。结论作为肾损伤的早期检测指标,血清Cys-C水平与外周血单个核细胞NF-κB活化率相关,Cys-C可能通过NF-κB参与细胞信号传导。Cys-C、NF-κB水平与老年高血压血管重构相关。

Objective To investigate the correlation of serum cystatin C（Cys - C）, nuclear factor-kB（NF -kB） with vascular re- modeling in elderly patients with hypertension. Methods The serum concentrations of Cys - C were measured by immunoturbidime try in 42 cases of elderly hypertension patients with normal renal function,48 cases of elderly hypertension patients with abnormal re- nal function and 46 cases of normal person. NF -kB activation expression rate was detected using immunohistochemical method. Vas- cular ultrasound was used to detect vascular remodeling. Results The level of Cys - C, NF -kB in patients with hypertension were significantly higher than normal control group. The serum concentrations of Cys - C and peripheral blood mononuclear cell NF -kB ac tivation rate were significantly positively correlated （r= 0.657, P〈0.01 ）. Serum level of Cys- C and endogenous creatinine clearance rate had significant negative correlation（r=- 0. 577, P%O. 01）. There were positive correlation among Cys - C, NF -kB levels and vascular remodeling indicators,which could be reflected by carotid artery diameter,intima media thickness and carotid artery plaque score and artery resistance index and pulsatility index. Conclusion Serum Cys - C was the early detection indicator of kidney injury. The level of serum Cys - C and peripheral blood monocyte NF -kB activation rate were significantly correlated. Cys - C possibly through NF -kB participates in the cell signal transduction. Both Cys - C and NF -kB were vascular remodeling indexes in elderly pa tients with hypertension.