女性更年期高血压患者的雌二醇水平与超敏C反应蛋白、胱抑素C、同型半胱氨酸、血压昼夜节律的关系

Correlation between estradiol level and high sensitive C-reactive protein,Cystatin C,homocysteine and circadian rhythm of blood pressure in female climacteric hypertension

目的探讨女性更年期高血压患者雌二醇(E2)水平与超敏C-反应蛋白(hs-CRP)、血清胱抑素C(CysC)、同型半胱氨酸(Hcy)、血压昼夜节律的关系,为女性更年期高血压患者的个体化治疗提供参考。方法80例女性更年期高血压患者作为高血压组,选取同期40例体检健康的女性作为对照组。所有受试者检查24 h动态血压,依据夜间血压下降率将高血压组患者分为非杓形组(52例)和杓形组(28例),比较两组受试者E2、hs-CRP、CysC、Hcy水平;高血压杓型组、非杓型组年龄、E2水平、血压。结果高血压组患者hs-CRP水平(10.36±3.25)mg/L、CysC水平(1.19±0.31)mg/L、Hcy水平(15.23±3.22)μmol/L均高于对照组的(4.07±1.98)mg/L、(0.90±0.25)mg/L、(7.84±1.95)μmol/L,E2水平(10.25±1.88)pg/ml低于对照组的(19.76±2.99)pg/ml,差异均具有统计学意义(P<0.05)。高血压非杓形组和杓形组患者的年龄比较,差异无统计学意义(P>0.05);非杓型组患者E2水平(8.76±1.86)pg/ml低于杓型组的(11.98±1.89)pg/ml,24 h收缩压(SBP)(142.16±17.13)mm Hg(1 mm Hg=0.133 kPa)、舒张压(DBP)(89.65±10.96)mm Hg均高于杓型组的(129.51±23.82)、(79.25±12.26)mm Hg,SBP夜间下降率(6.65±2.27)%、DBP夜间下降率(7.21±2.51)%均低于杓型组的(13.80±3.36)、(12.67±2.34)%,差异均具有统计学意义(P<0.05)。结论女性更年期高血压E2水平下降与hs-CRP、CysC、Hcy升高相关,且雌激素水平与血压昼夜节律性相关,监测其变化,对女性更年期高血压患者的个体化治疗有着重要的临床价值。

Objective To discuss the correlation between estradiol(E2)level and high sensitive C-reactive protein(hs-CRP),Cystatin C(CysC),homocysteine(Hcy)and circadian rhythm of blood pressure in female climacteric hypertension,so as to provide reference for individual treatment of female climacteric hypertension.Methods There were 80 female patients with climacteric hypertension selected as the hypertension group,and 40 healthy examinee as the control group.All subjects underwent 24-h ambulatory blood pressure examination.According to the night-time drop rate of blood pressure,the patients in hypertension group were divided into nonscoop-shaped group(52 cases)and scoop-shaped group(28 cases).The levels of E2,hs-CRP,CysC and Hcy in the two groups was compared,and age,E2 level and blood pressure between scoop-shaped group and non-scoopshaped group was compared.Results hs-CRP(10.36±3.25)mg/L,CysC(1.19±0.31)mg/L,Hcy(15.23±3.22)μmol/L of hypertension group was higher than those of the control group(4.07±1.98)mg/L,(0.90±0.25)mg/L,(7.84±1.95)μmol/L,and E2(10.25±1.88)pg/ml was lower than that of the control group(19.76±2.99)pg/ml,and the difference was statistically significant(P<0.05).There was no statistically significant difference in age between non-scoop-shaped group and scoop-shaped group(P>0.05).E2(8.76±1.86)pg/ml of non-scoop-shaped group was lower than scoop-shaped group(11.98±1.89)pg/ml,24-h systolic blood pressure(SBP)(142.16±17.13)mm Hg(1 mm Hg=0.133 kPa)and diastolic blood pressure(DBP)(89.65±10.96)mm Hg was higher than those of scoop-shaped group(129.51±23.82)and(79.25±12.26)mm Hg,night-time drop rate of SBP(6.65±2.27)%,night-time drop rate of DBP(7.21±2.51)%was lower than those of scoop-shaped group(13.80±3.36)and(12.67±2.34)%,and the difference was statistically significant(P<0.05).Conclusion The decrease of estrogen level in female climacteric hypertension is positively correlated with the increase of hs-CRP,CysC and Hcy,and the estrogen level is correlated with the circadian rhythm of blood pressure.Monitoring its changes has important clinical value for the individual treatment of female menopausal hypertension patients.