血清高敏C反应蛋白浓度与高血压病的临床相关性分析

Clinical Correlation Analysis of concentration of Serum hypersensitive C-reactive protein and Hypertension

目的高血压与动脉硬化密切相关，血压变异性（blood pressure variability，BPV）是指血压在一定时期内的血压波动程度。最近的研究表明，BPV的异常与器官功能受损相关。本研究旨在探讨高血压病患者血压波动性与脉搏波传导速度（pulse wave velocity，Pwv）和高敏C反应蛋白（high sensitive C—reactiveprotein，hsCRP）的关系。方法收集2015年10月-2016年5月垡头社区卫生服务中心双合卫生站的原发性高血压患者101例。采用24h动态血压监测对高血压患者24h、收缩压和舒张压的变化进行分析。使用柯林VPl000自动动脉硬化仪，同时记录和分析包括肢体血压、脉压、肱动脉脉搏波速度（brachial—anklepulsewavevelocity，BAPWV）的血清hsCRP，用酶标多克隆抗体夹心法测定。分析血压变异性与BAPWV的关系。结果BAPWV随平均收缩压、夜间平均收缩压、全天平均收缩压、平均脉压差（pulsepressure，PP）升高（r=0．292、0．328、0．312、0．289、P〈0．05）。在正常BAPWV患者和BAPWV增高患者中，BAPWV、年龄、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、PP、hsCRP、空腹血糖（1eftcircumflexartery，FPG）和血尿酸水平均高于正常的BAPWV（P〈0．05）；进一步相关分析，BAPWV与年龄、收缩压（systolicbloodpressure，SBP）的变化，FPG与hsCRP呈显著正相关。BAPWV、hsCRP呈正相关（P〈0．05）。年龄、FPG、hsCRP是影响BAPWV的独立因素（P〈0．01）。线性回归分析显示，调整平均血压和其他相关因素后，24h收缩压的变化与BAPWV和炎性细胞因子hsCRP呈正相关（r=0．315，0．328，0．392，0．354，P〈0．05）。收缩压与BAPWV和hsCRP呈正相关（P〈0．05）。结论随着收缩压的变化，BAPWV和hsCRP随之增加。高血压患者的hsCRP水平反映了高血压的严重程度，对高血压的评价有一定的临床意义。

Objective hypertension is closely related to arteriosclerosis. Blood pressure variability （BP） is the degree of blood pressure fluctuation in a certain period. Recent studies have shown that abnormalities in BPV are independently associated with impaired target organ function. The purpose of this study was to investigate the relationship between blo0d pressure volatility and pulse wave velocityV （PWV） and high sensitive C-reactive protein （hsCRP） in patients with essential hypertension. To explore the changes of blood pressure in patients with hypertension. Pulse velocity and the effect of hypersensitive C-reactive protein. Methods from October 2015 to May 2016, 101 patients with hypertension were admitted to our community. 24 hours ambulatory blood pressure monitoring was used to analyze the changes of systolic and diastolic blood pressure in patients with hypertension at 24 hours, day and night. The serum hsCRP, including limb blood pressure, pulse pressure and brachial artery pulse wave velocity, were recorded and analyzed by using Colin VP1000 automatic arteriosclerosis instrument. The serum hsCRP was measured by enzyme-labeled polyclonal antibody sandwich method. Analysis of blood pressure variability and fatty artery vein The relationship between braehial-ankle pulse wave velocity, velocity and hsCRP.Results brachial-ankle pulse wave velocityof brachial-ankle pulse wave BAPWV） with mean systolic bloodpressure, nighttime mean systolic blood pressure, whole day mean systolic blood pressure, and mean pulse pressure difference, the mean pulse pressure （PP） increased （P 〈 0.05）. Patients with normal arterial pulse wave velocity and brachial-ankle pulse wave velocity BAPWV） and those with higher arterial pulse wave velocity and brachial-ankle pulse wave velocity BAPWV） were found in patients with normal arterial pulse wave velocities and brachial-ankle pulse wave velocity BAPWVs. The Brachial-ankle pulse wave velocity （BAPWV） age, the systolic pressure （Systolic blood pressure, SBP）, the diastolic pressure （Diastolic blood pressure）, the average pulse pressure, the high sensitive protein, the high sensitive protein, the empty stomach blood. The levels of left circumflex and uric acid were higher than those of normal fatty artery pulse wave velocity （Brachial-ankle pulse wave velocityl） and BAPWVV （P 〈 0.05）. Further correlation analysis showed that the systolic blood pressure （SBP） of fatty artery pulse wave velocity （BAPWV） was higher than that of normal fatty artery pulse wave velocity （Brachial-ankle pulse wave velocityBAPWV） with age （P ~ 0.05）. There was a significant positive correlation between left circumflex and hsCRP. Brachial-ankle pulse wave velocities （BAPWV） and Gao Min C-reactive protein （hsCRP） were positively correlated with brachial-ankle pulse wave velocityBAPWV （P 〈0.05 ）. Age, fasting plasma glucose （FPG）, hsCRP were independent factors which affect the pulse wave velocity （BAPV） of fatty ! - step artery （P〈O.01）. Linear regression analysis showed that the changes of systolic blood pressure during the day, night and 24 hours after adjustment of mean blood pressure and other related factors There was a positive correlation between brachial-ankle pulse wave velocityl （BAPWV） and hsCRP of inflammatory cytokine hsCRP （P 〈0.05）. Resting blood pressure and arterial pulse wave velocity BAPWV） and hsCRP were positively correlated with Gao Min C-reactive protein （hsCRP） （P 〈0.05）. BAPWV and hsCRP increased with the change of systolic blood pressure. Conclusion hsCRP is high in patients with hypertension. The level of ensitive C-reactive protein hsCRP reflects the severity of hypertension and the degree of left ventricular remodeling.