血清心肌酶检测在不同分级高血压患者诊断中的临床意义

Clinical significance of detection of serum myocardial enzymes in diagnosis of patients with different grades of hypertension

目的探讨血清心肌酶检测在不同分级高血压患者诊断中的临床意义。方法 选择2014年1月~2015年12月在新疆维吾尔自治区人民医院门诊就诊及住院的原发性高血压（高血压组）患者225例作为研究对象,按照WHO规定的高血压分级标准分为三组,分别为高血压1级组（n=75）、高血压2级组（n=77）、高血压3级组（n=73）,同时选择与高血压组年龄相当的66名健康体检者作为对照组。测定血清肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、α羟丁酸脱氢酶（α-HBDH）、血脂水平。结果 高血压1、2、3级各组收缩压（SBP）、舒张压（DBP）水平明显高于对照组（P〈0.05）,且随着高血压级别的增加,SBP、DBP水平也逐渐增加（P〈0.05）。但高血压1、2、3级各组总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平分别与对照组比较,差异无统计学意义（P〉0.05）;高血压1级组血清CK水平与对照组比较,差异无统计学意义（P〉0.05）,高血压2、3级组血清CK水平分别显著高于高血压1级组及对照组,差异有统计学意义（P〈0.05）;高血压1、2级组血清CK-MB水平组间比较,差异无统计学意义（P〉0.05）,且高血压1、2级组分别与对照组比较,差异无统计学意义（P〉0.05）,但高血压3级组血清CK-MB水平显著高于高血压1、2级组及对照组（P〈0.05）;高血压1、2、3级各组血清LDH、α-HBDH水平均显著高于对照组（P〈0.05）,且随着高血压分级逐渐增加,血清LDH、α-HBDH水平也逐渐增加（P〈0.05）。血清CK、CK-MB、LDH、α-HBDH水平与高血压分级分别呈正相关。结论 随着高血压分级水平的增高,血清CK、CK-MB、LDH、α-HBDH水平也逐渐上升,心肌酶谱相关指标的检测可作为高血压患者诊断及评估的补充手段。

Objective To investigate the clinical significance of detection of serum myocardial enzyme in diagnosis of patients with different grades of hypertension. Methods Two hundred and twenty-five cases of outpatients and inpatients with primary hypertension（hypertension group） in Xinjiang Autonomous Region People＇s Hospital from January 2014 to December 2015 were selected as research objects, according to the WHO classification standard, they were divided into 3 groups, which were grade 1 hypertension group（n = 75）, grade 2 hypertension group（n = 77）, grade 3 hypertension group（n = 73） respectively, at the same time, 66 cases of healthy subjects（control group, n = 66） who had similar ages with hypertension group were selected as control. The levels of serum creatine kinase（CK）, creatine kinase isoenzyme（CK-MB）, lactate dehydrogenase（LDH）, α-hydroxybutyrate de-hydrogenase（α-HBDH） and blood lipid were detected. Results The levels of systolic blood pressure（SBP）, diastolic blood pressure（DBP） in grade 1, 2, 3 hypertension group were significantly higher than those of the control group（P 0.05）, and with the increase of levels of blood pressure, the levels of SBP, DBP were gradually increased（P 0.05）. But the levels of total cholesterol（TC）, triacylglycerol（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterin（LDL-C） in grade 1,2, 3 hypertension group had no statistically significant differences compared with those of control group（P 0.05）; the serum CK levels of grade 1 hypertension group had no statistically significant difference compared with that of the control group（P 0.05）, the serum CK levels of grade 2, 3 hypertension group were higher than those of grade 1 hypertension group and control group, the differences were statistically significant（P 0.05）; the serum CK-MB level between grade 1 hypertension group and grade 2 hypertension group had no statistically significant difference（P 0.05）,and the serum CK-MB levels of grade 1, 2 hypertension group had no statistically significant differences compared with that of control group（P 0.05）, but the serum CK-MB levels of grade 3 hypertension group were significantly higher than those of grade 1, 2 hypertension group and control group（P 0.05）; the levels of serum LDH, α-HBDH in grade1, 2, 3 hypertension group were all significantly higher than those of control group（P 0.05）, and with the increase of levels of blood pressure, the levels of LDH, α-HBDH were gradually increased（P 0.05）. The levels of serum CK,CK-MB, LDH, α-HBDH were positively correlated with the grade of hypertension. Conclusion With the increase of hypertension grade, the levels of serum CK, CK-MB, LDH, α-HBDH are increased gradually, the detection of serum myocardial enzymes related indexes can be used as a supplementary means for the diagnosis and assessment of patients with hypertension.