清道夫受体CD36基因缺陷对正常高值血压患者动态血压参数的影响

Effect of scavenger receptor CD36 gene defect on ambulatory blood pressure monitoring parameters in patients with high-normal blood pressure

目的探讨CD36基因缺陷对正常高值血压患者24 h动态血压参数的影响。方法连续入选2018年10月至2019年2月在武汉市武昌医院心内科门诊就诊的200例初诊正常高值血压患者为研究对象,以筛查出有CD36基因缺陷的31例患者为观察组,以169例CD36基因正常的患者为对照组。2组患者均行24 h动态血压监测,比较24 h动态血压参数的差异,并分析其与CD36基因缺陷之间的相关性。结果观察组夜间平均收缩压和24 h平均舒张压高于对照组[(115.1±4.9)mm Hg(1 mm Hg=0.133 k Pa)比(100.7±4.3)mm Hg、(76.3±3.7)mm Hg比(68.7±3.4)mm Hg](均P=0.05);观察组24 h平均动脉压明显高于对照组[(102.6±7.3)mm Hg比(89.4±5.8)mm Hg](P=0.01),非杓型血压比例明显高于对照组[74.2%(23/31)比29.0%(49/169)](P<0.01)。Logistic逐步回归分析显示,CD36基因缺陷与正常高值血压患者24 h平均动脉压升高、动态血压节律改变(非杓型血压)具有相关性(比值比=5.876,95%置信区间:4.461~15.128,P=0.001;比值比=6.235,95%置信区间:4.896~16.882,P=0.001)。结论清道夫受体CD36基因缺陷可能对正常高值血压患者的动态血压节律和平均动脉压产生影响。

Objective To observe the effect of CD36 gene defect on 24 h ambulatory blood pressure monitoring parameters in patients with high-normal blood pressure.Methods A total of 200 patients with high-normal blood pressure were enrolled from October 2018 to February 2019 in Wuhan Wuchang Hospital.Genomic DNA testing showed that 31 patients had CD36 gene defect(observation group)and 169 patients had normal CD36 gene(control group).The 24 h ambulatory blood pressure monitoring was performed in both groups.The relation between 24 h ambulatory blood pressure monitoring parameters and CD36 gene defect was analyzed.Results Nocturnal mean systolic blood pressure and 24 h mean diastolic pressure in observation group were higher than those in control group[(115.1±4.9)mm Hg vs(100.7±4.3)mm Hg,(76.3±3.7)mm Hg vs(68.7±3.4)mm Hg](both P=0.05);24 h mean arterial pressure in observation group was significantly higher than that in control group[(102.6±7.3)mm Hg vs(89.4±5.8)mm Hg](P=0.01).Non-dipper blood pressure rate in observation group was significantly higher than that in control group[74.2%(23/31)vs 29.0%(49/169)](P<0.01).Logistic stepwise regression showed that CD36 gene defect was correlated with the rise of 24 h mean arterial pressure and the change of ambulatory blood pressure rhythm(non-dipper blood pressure)(odds ratio=5.876,95%confidence interval:4.461-15.128,P=0.001;odds ratio=6.235,95%confidence interval:4.896-16.882,P=0.001).Conclusion CD36 gene defect may affect ambulatory blood pressure rhythm and mean arterial pressure in patients with high-normal blood pressure.