老年原发性高血压患者血清β2微球蛋白和踝臂指数的改变及其与血压变异性的关系

Study of serumβ-microglobulin,ankle-brachial index and blood pressure variability in elderly patients with essential hypertension

目的探讨老年原发性高血压患者血清β2微球蛋白(β2-MG)和踝臂指数的改变及其与血压变异性(BPV)的关系。方法选择2016年7月至2017年6月河北省保定市第二医院收治的147例老年原发性高血压患者为观察组,同期在本院健康体检者50例为对照组,检测并比较2组血清β2-MG水平及踝臂指数,检测并比较2组血压参数[24 h平均舒张压(24 h DBP)、24 h平均收缩压(24 h SBP)、24 h舒张压变异率(24 h DBPV)、24 h收缩压变异率(24 h SBPV)],采用Pearson相关分析法分析原发性高血压患者β2-MG、踝臂指数与24 h DBP、24 h SBP、24 h DBPV、24 h SBPV的相关性,采用多元线性回归方法分析原发性高血压患者24 h DBPV、24 h SBPV的影响因素。结果观察组血清β2-MG水平明显高于对照组,踝臂指数明显低于对照组[(4.08±0.54)mg/L比(1.59±0.11)mg/L、(0.95±0.28)比(1.16±0.09)],差异均有统计学意义(均P<0.01)。观察组24 h DBP、24 h SBP、24 h DBPV、24 h SBPV明显大于对照组,差异均有统计学意义(均P<0.01)。原发性高血压患者血清β2-MG水平与24 h DBP、24 h SBP、24 h DBPV、24 h SBPV均呈正相关(均P<0.01);踝臂指数与24 h DBP、24 h SBP、24 h DBPV、24 h SBPV均呈负相关(均P<0.01)。β2-MG、踝臂指数是原发性高血压患者24 h DBPV、24 h SBPV的影响因素(非标准化回归系数分别为1.533、-0.188,1.820、-8.139,均P<0.01)。结论老年原发性高血压患者血清β2-MG水平呈升高趋势,踝臂指数呈下降趋势,二者均与BPV相关,BPV随血清β2-MG水平升高、踝臂指数下降而增高。

Objective To investigate the changes of serumβ2-microglobulin(β2-MG)and ankle-brachial index(ABI)in elderly patients with essential hypertension and therelation with blood pressure variability(BPV).Methods From July 2016 to June 2017,147 elderly patients with essential hypertension(observation group)and50 health people(control group)were enrolled at Baoding Second Hospital,Hebei Province.Serumβ2-MG,ABI and blood pressure parameters[24 h mean diastolic blood pressure(24 h DBP),24 h mean systolic blood pressure(24 h SBP),24 h diastolic blood pressure variability(24 h DBPV),24 h systolic blood pressure variability(24 h SBPV)]were detected.Pearson correlation test was used to determine the correlation amongβ2-MG,ABI,24 h DBP,24 h SBP,24 h DBPV and 24 h SBPV.Multivariate linear regression was used to analyze the influence factors of 24 h DBPV and 24 h SBPV.Results Serumβ2-MG level in observation group was significantly higher and ABI was lower than those in control group[(4.08±0.54)mg/L vs(1.59±0.11)mg/L,(0.95±0.28)vs(1.16±0.09)](both P<0.01).Values of 24 h DBP,24 h SBP,24 h DBPV and 24 h SBPV in observation group were significantly higher than those in control group(all P<0.01).Serumβ2-MG level in hypertension patients was positively correlated with 24 h DBP,24 h SBP,24 h DBPV and 24 h SBPV(all P<0.05);ABI was negatively correlated with 24 h DBP,24 h SBP,24 h DBPV and 24 h SBPV(all P<0.01).Serumβ2-MG level and ABI were influence factors of 24 h DBPV and 24 h SBPV(non-standardized regression coefficients:1.533,-0.188,1.820,-8.139;all P<0.01).Conclusions Elderly patients with essential hypertension show highserumβ2-MG level and low ABI.BPV increase with serumβ2-MG level and it is negatively related to the change of ABI.