清晨高血压患者血清Lp-PLA_2水平与颈动脉硬化的相关性

Correlation between serum Lp-PLA_2 level and carotid atherosclerosis in patients with morning hypertension

目的:研究清晨高血压(MH)患者血清脂蛋白相关磷脂酶A2(Lp-PLA_2)水平与颈动脉粥样硬化(AS)的相关性。方法:选择2014年12月～2017年3月我科门诊或住院的高血压患者160例。根据清晨高血压的诊断标准,患者被分为MH组(85例)和非MH组(75例)。检测比较两组血脂、空腹血糖(FBG)、血清Lp-PLA_2水平及颈总动脉内-中膜厚度(IMT)、斑块检出率,分析血清Lp-PLA_2水平与颈动脉硬化的相关性。结果:两组血脂、FBG水平均无显著差异,P均>0.05。与非MH组比较,MH组血清Lp-PLA_2水平[(47.50±3.15)μg/L比(156.87±18.56)μg/L]和斑块检出率(66.6%比90.6%)显著升高,颈动脉IMT[(0.96±0.12)mm比(1.26±0.16)mm]显著增厚,P均=0.001。Spearman等级相关分析显示,血清Lp-PLA_2水平与颈动脉斑块检出率呈显著正相关(r=0.532,P=0.003)。结论:清晨高血压患者血清Lp-PLA_2水平较非清晨高血压患者显著升高,且与颈动脉硬化呈显著正相关,故对此类患者应加强Lp-PLA_2水平和动脉硬化检测,争取早期诊断和治疗。

Objective: To study correlation between serum level of lipoprotein-associated phospholipase A2 (Lp-PLA 2 ) and carotid atherosclerosis (AS) in patients with morning hypertension (MH). Methods: A total of 160 MH patients, who visited or hospitalized in our department from Dec 2014 to Mar 2017, were selected. According to diagnostic standard of MH, patients were divided into MH group (n=85) and non-MH group (n=75). Levels of blood lipids, fasting blood glucose (FBG), serum Lp-PLA 2 , carotid intima-media thickness (IMT) and plaque detection rate were measured and compared between two groups, and the correlation between serum Lp-PLA 2 level and carotid AS was analyzed. Results: There were no significant difference in levels of blood lipids and FBG between two groups, P >0.05 all. Compared with non-MH group, there were significant rise in serum Lp-PLA 2 level [(47.50±3.15)μg/L vs.(156.87±18.56)μg/L], plaque detection rate (66.6% vs. 90.6%) and carotid IMT [(0.96±0.12)mm vs.(1.26±0.16)mm] in MH group, P =0.001 all. Spearman rank correlation analysis indicated that serum Lp-PLA 2 level was significant positively correlated with carotid plaque detection rate ( r =0.532, P =0.003). Conclusion: Serum Lp-PLA 2 level of MH patients is significantly higher than that of non-MH patients, and it's significant positively correlated with carotid AS. Therefore, the Lp-PLA 2 level and atherosclerosis detections should be enhanced for early diagnosis and treatment.