原发性高血压患者血清尿酸和胱抑素C与心室重构的相关性

Association between serum uric acid and cystatin C and ventricular remodeling in patients with essential hypertension

目的:探讨原发性高血压患者血清尿酸(UA)和胱抑素C(CysC)与血压水平及左室重构程度之间的关系。方法:选择2016年9月至2018年6月沈阳医学院附属第二医院心内科收治的原发性高血压患者330例,根据2010年修订版《中国高血压病防治指南》诊断标准分为高血压1级组90例、高血压2级组106例和高血压3级组134例,非高血压患者119例作为对照组。抽取患者静脉血进行生化检测,用彩色超声心动图检测心脏结构指标,比较所有患者的UA、CysC、左心室质量指数(LVMI)并分析是否具有相关性。结果:原发性高血压组与对照组一般资料比较,差异均无统计学意义(P>0.05)。原发性高血压组UA、CysC、LVMI、左心室质量(LVM)明显高于对照组(P<0.05)。不同级别(1-3级)高血压患者UA、CysC及LVMI水平随血压级别的升高而递增,且组间比较,差异均有统计学意义(P<0.05)。经Pearson相关分析显示,收缩压(SBP)与UA、CysC、LVMI均呈正相关(r=0.548、0.336、0.565,P<0.05);LVMI与UA、CysC均呈正相关(r=0.451、0.279,P<0.05)。LVMI与相关指标行Logistic多元回归分析结果显示UA、SBP是LVMI的独立危险因素。结论:血压级别的高低与UA、CysC、LVMI之间具有相关性。SBP水平、UA、CysC对左心室重构程度均有影响作用。UA、SBP是影响心室重构的独立危险因素。

Objective: To investigate the relationship between serum uric acid (UA) and cystatin C(CysC), blood pressure and left ventricular remodeling in patients with essential hypertension. Methods: A total of 330 patients with essential hypertension from Sep 2016 to Jun 2018 were enrolled. According to the diagnostic criteria of the 2010 revised guidelines for the prevention and treatment of hypertension in China, the patients were divided into hypertension level 1(n=90), hypertension level 2(n=106) and hypertension level 3 (n=134), and 119 patients without hypertension were taken as the control group. Serum UA and CysC, left ventricular mass(LVM)and left ventricular mass index(LVMI) were compared. Results: The general data between essential hypertension group and control group had no statistically significant difference (P>0.05). UA, CysC, LVMI and LVM in essential hypertension group was significantly higher than that in the control group (P<0.05). UA, CysC and LVMI levels in essential hypertension group with different grades (1-3) increased with the increase of blood pressure level, and the differences between groups were statistically significant (P<0.05). Pearson correlation analysis showed that SBP was positively correlated with UA, CysC and LVMI(r = 0.548, 0.336, 0.565, P<0.05). LVMI was positively correlated with UA and CysC (r = 0.451, 0.279, P<0.05). Logistic multiple regression analysis showed that UA and SBP were independent risk factors for LVMI. Conclusions: Blood pressure level is correlated with UA, CysC and LVMI.Systolic blood pressure level,UA and CysC have an effect on the degree of left ventricular remodeling. UA and SBP are the independent risk factors affecting ventricular remodeling.