摘要
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.
出处
《中国循环杂志》
CSCD
北大核心
2017年第4期358-361,共4页
Chinese Circulation Journal
基金
山西省社会发展基金(20120313018-8)