高血压病人颈动脉重构与脂蛋白(a)、氧化型低密度脂蛋白关系的探讨

Relationship between remodeling of carotid and lipoprotein(a) and oxidized low density lipoprotein in hypertensive patients

目的 探讨高血压病人血清中氧化型低密度脂蛋白(ox-LDL)、脂蛋白(a)(Lp(a))的变化及其与高血压病人颈动脉重构的相互关系。方法 选取原发性高血压病人43例,健康自愿者40例作为观察对象。应用二维超声测定颈动脉结构与功能改变,应用酶联免疫吸附法测定ox-LDL及LP(a)。结果 原发性高血压组Lp(a)及ox-LDL较正常对照组显著升高(P<0.05)。直线相关分析显示,Lp(a)与原发性高血压组颈动脉内膜-中层厚度(IMT)呈正相关(r=0.204,P<0.01),与颈动脉扩张性(CD)无关。ox-LDL与原发性高血压组颈动脉IMT呈正相关(r=0.389,P<0.01),与CD呈负相关(r=-0.386,P<0.05)。结论 高血压病人血清中氧化型低密度脂蛋白及脂蛋白(a)水平较健康人增加。氧化型低密度脂蛋白与高血压病人颈动脉结构及功能改变相关,而脂蛋白(a)仅与颈动脉结构改变有关,可能与颈动脉功能改变无关。

Objective The purposes of this study were to investigate changes of oxidized low density lipoprotein (ox-LDL) and lipoprotein (a) (Lp(a)),and to evaluate relationship between remodeling of carotid and ox-LDL and Lp(a) in hypertensive patients. Methods Forty three essential hypertension patients (EH group) and forty healthy people (normal control group, NC group) were observed. Remodeling of carotid was assessed with high-resolution B-mode ultrasonography. ox-LDL and Lp(a) were determined in method of enzyme linked immunosorbent assay (ELISA). Results ox-LDL and Lp(a) were significantly higher in EH group than NC group (P<0. 05). ox-LDL was significantly positive association with intima-media thickness (IMT).and was significantly related negative to carotid disensibility (CD) in EH group.Lp(a) was significantly positive association with IMT,but was not related to CD in EH group. Conclusions Serum ox-LDL and Lp(a) level increase in hypertensive patients. Remodel of carotid has close relationship with ox-LDL in hypertensive patients. It is not change of function but only structure of carotid that closely related to Lp(a) in hypertensive patients.