原发性高血压患者血清胱抑素C与血管内皮功能的相关性

Association between serum cystatin C and vascular endothelial function in patients with essential hypertension

目的探讨原发性高血压患者血清胱抑素C与血管内皮功能的相关性。方法选取山西医科大学附属第一医院高血压病区的原发性高血压患者232（男130、女102）例,正常血压组87人,年龄40~70岁。超声检测肱动脉血流介导的血管舒张功能（FMD）,按照FMD值将受试者分为FMD≥6.0%（n=118）与FMD〈6.0%组（n=114）。检测血清胱抑素C、血肌酐、空腹血糖、血脂及尿微量白蛋白（尿MA）水平。采用多元线性回归分析血清胱抑素C与FMD的关系。结果FMD≥6.0%组的血清胱抑素C浓度低于FMD〈6.0%组[（0.99±0.27）比（1.14±0.23）mg/L,P〈0.05]。高血压1级、2级组FMD高于高血压3级组（P〈0.05）,胱抑素C低于高血压3级组（P〈0.05）。随着血清胱抑素C浓度的升高,FMD呈减低趋势（P〈0.05）。FMD与胱抑素C、年龄、收缩压、尿MA呈负相关（分别r=-0.217,-0.362,-0.234,-0.224;均P〈0.05）。多元线性回归分析显示,校正性别、吸烟等因素后,胱抑素C仍是FMD的影响因素（B=-2.523,P〈0.05）。结论原发性高血压患者血清胱抑素C与血管内皮功能呈负相关。

Objective To investigate the association between serum cystatin C and vascular endothelial function in patients with essential hypertension. Methods A total of 232 hypertensive patients aged 40-70 years,including130males and 102 females,in the First Affiliated Hospital of Shanxi Medical University were enrolled. Another 87 subjects without clinical evidence of hypertension were recruited as the control group. According to flow mediated vasodilation（FMD）measured by ultrasound,all patients with essential hypertension were divided into the normal vascular endothelial function group（FMD≥6.0%,n=118）or the impaired vascular endothelial function group（FMD〈6.0%,n=114）. Serum cystatin C,creatinine,fasting glucose,serum lipids and urine microalbumin were measured. The relationship between serum cystatin C and FMD was analyzed using linear regression analysis.Results Serum cystatin C was significantly lower in the normal vascular endothelial function group than in the impaired vascular endothelial function group[（0.99±0.27）vs（1.14±0.23）mg/L,P〈0.05].Compared to patients with grade 3hypertension,FMD was significantly higher while serum cystatin C was significantly lower in patients with grade 1and 2hypertension（both P〈0.05）. With the increase of serum cystatin C concentration,FMD exhibited a reduced trend（P〈0.05）. FMD was negatively correlated with serum cystatin C,age,systolic blood pressure and microalbumin（r=-0.217,-0.362,-0.234and-0.224,all P〈0.05）. After adjusting for various confounders,Multivariate linear regression analysis revealed that serum cystatin C was significantly associated with FMD（B=-2.523,P〈0.05）. Conclusion Serum cystatin C was negatively correlated with vascular endothelial function in patients with essential hypertension.