高血压前期合并超重人群超敏C反应蛋白与颈动脉内中膜厚度的相关性分析

High sensitive C-reactive protein and carotid intima-media thickness in prehypertension patients with overweight

目的 观察高血压前期合并超重人群的超敏C反应蛋白(hs-CRP)及颈动脉内中膜厚度(IMT),探讨两者的相关性.方法 入选符合纳入标准的2017年2月至2018年4月在我院门诊及体检中心就诊人群280例.根据血压和体质量指数分为三组:正常对照组50例,单纯高血压前期组118例,高血压前期合并超重组112例.比较三组人群hs-CRP、IMT,并分析hs-CRP与IMT之间的关系.结果 hs-CRP、IMT水平在高血压前期合并超重组最高,其次为单纯高血压前期组、正常对照组[分别为(1.95±1.51)mg/L比(1.46±1.39) mg/L比(0.84±0.95)mg/L,(1.23±0.37)mm比(0.99±0.27)mm比(0.85±0.12)mm],三组间差异均有统计学意义(P<0.05);根据hs-CRP水平将高血压前期人群分为低危组(<1.0 mg/L) 96例,中危组(1.0~3.0mg/L) 90例,高危组(>3.0 mg/L)44例,IMT在三组间逐步升高[(0.89±0.15)mm比(1.11±0.22)mm比(1.24±0.31)mm],三组间差异均有统计学意义(P<0.05).与低危组相比,中危组、高危组发生颈动脉内中膜增厚的优势比OR分别为3.55(95%CI1.92~6.57)、11.04(95%CI4.66~26.17),差异均有统计学意义(P<0.05);多元逐步回归结果显示,hs-CRP为IMT的独立显著影响因素,相关系数β=0.325,P<0.01,所有自变量VIF<10.结论 高血压前期人群已出现血管重塑,合并超重会加重血管损伤,应当早期防治,综合管理;hs-CRP参与了高血压前期人群的血管损伤过程,在一定程度上可以反映其血管受损程度.

Objective To explore the association of high sensitivity C-reactive protein(hs-CRP) and carotid intima-media thickness (IMT) in prehypertension patients with overweight. Methods A total 280 subjects in outpatient department and physical examination center of our hospital were selected from February 2017 to April 2018. They were classified into three groups by blood pressure and body mass index(BMI): the normal group(n=50), the prehypertension group(n=118) and the prehypertension with overweight group(n=112). Serum biochemical indicators, hs-CRP and IMT were compared between the three groups, analyzing the association between hs-CRP and IMT. Results IMT and hs-CRP were gradually increased in the normal group, the prehypertension group and the prehypertension with overweight group[(0.84±0.95)mg/L vs.(1.46±1.39)mg/L vs.(1.95±1.51)mg/L,(0.85±0.12)mm vs.(0.99±0.27)mm vs.(1.23±0.37)mm, respectively], the difference was statistically significant(P<0.05). All prehypertensions were divided into three groups according to the level of hs-CRP. It was found that with the increase of hs-CRP level, IMT gradually increased[(0.89±0.15)mm vs.(1.11±0.22)mm vs.(1.24±0.31)mm]. Compared with the low-risk group, the odds ratio of carotid endometriosis in the medium-risk group and high-risk group was 3.55(95%CI 1.92-6.57) and 11.04(95%CI 4.66-26.17) respectively(P <0.05). Further multivariate stepwise regression analysis using IMT as the dependent variable shows that hs-CRP is a significant influence factor of IMT. Conclusion Vascular remodeling has existed in the prehypertension. Early prevention and treatment,comprehensive management of prehypertension should be carried out. Hs-CRP is involved in the process of vascular remodeling.To some extent,hs-CRP could reflect the degree of vascular remodeling.