高血压患者发生急性冠状动脉综合征相关临床和生化标记物因素分析

Analysis for Relevant Clinical Parameters and Biomarkers in Patients of Essential Hypertension Combining Acute Coronary Syndrome

目的:分析原发性高血压患者发生急性冠状动脉综合征(ACS)与炎性因子和相关高危因素的关系,并探讨其临床意义。方法:选择符合纳入标准的原发性高血压组患者79例,原发性高血压并发ACS组患者85例,选取健康人48例作为对照组,测定每组患者的相关临床生化指标和血清脂蛋白相关磷脂酶A2(LP-PLA2)、类胰蛋白酶(TPS)水平,统计每组患者的心血管疾病危险因素,运用Logistic回归分析上述生化指标、炎性因子和危险因素对原发性高血压患者并发ACS的意义。结果 :纤维蛋白原(Fbg)、超敏C反应蛋白(hs-CRP)、TPS和动脉粥样硬化(AS)斑块、LP-PLA2、原发性高血压分级的OR值均大于1,其中Fbg是最有意义的独立危险因素(OR:22.242,95%CI:6.458~76.609,P<0.001),其标化偏回归系数b’绝对值在6个变量中最大(b’:1.079),对原发性高血压患者发生ACS的影响最大。结论:Fbg、hs-CRP、LP-PLA2、TPS和动脉粥样硬化斑块、原发性高血压分级是原发性高血压患者发生ACS的重要独立危险因素,其中Fbg是原发性高血压发生ACS最强的独立危险因素,Fbg对原发性高血压患者发生ACS的影响最大,为ACS的预防或治疗提供了新的方向。

Objective： To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension （EH） combining acute coronary syndrome （ACS） with its clinical significance. Methods： Our research included 3 groups： EH group, n=79 patients with standard criteria, EH＋ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 （Lp-PLA2）, tryptase （TPS） and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results： The OR values were all greater than 1 in fibrinogen （Fbg）, high-sensitivity C-reactive protein （hs-CRP）, TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor （OR=22.242, 95% CI 6.458-76.609, P〈0.0001）, the standardized partial regression coefficient b＇as absolute value （b＇） was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion： Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.