N末端脑钠肽前体和中性粒细胞与高血压患者颈动脉内膜中层厚度的相关性分析

Correlation analysis of N-terminal pro-brain natriuretic peptide,neutrophil and carotid artery intima-media thickness in patients with hypertension

目的探讨血浆N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)和中性粒细胞(neutrophil,NEU)水平与高血压患者颈动脉内膜中层厚度(intima-media thickness,IMT)相关性。方法选取2017年6月至2020年6月于合肥市第二人民医院就诊的高血压患者90例纳入观察组,根据颈动脉IMT值,将观察组患者分为正常组(IMT<0.9 mm,32例)、增厚组(0.9 mm≤IMT<1.2 mm,31例)和斑块组(IMT≥1.2 mm,27例)3个亚组。再选取同期该院健康体检者90例纳入对照组。观察并比较两组研究对象收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、空腹血糖(fasting plasma glucose,FPG)、血清总胆固醇(total cholesterol,TC)、甘油三酯(triacylglycerol,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、NT-proBNP、NEU水平。采用Pearson相关分析探讨血浆NT-proBNP、NEU水平与高血压患者颈动脉IMT的相关性。绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线),以曲线下面积(area under the curve,AUC)评价血浆NT-proBNP、NEU水平对高血压患者颈动脉IMT的预测价值。结果观察组患者SBP、TC、TG、LDL-C、NT-proBNP、NEU水平均显著高于对照组(均P<0.05),HDL-C水平显著低于对照组(P<0.05)。斑块组、增厚组患者血浆NT-proBNP、NEU水平均显著高于正常组(均P<0.05),且斑块组患者血浆NT-proBNP、NEU水平均显著高于增厚组(均P<0.05)。Pearson相关分析显示,血浆NT-proBNP、NEU水平与高血压患者颈动脉IMT均呈正相关(r=0.805、0.758,均P<0.001)。血浆NT-proBNP、NEU预测高血压患者颈动脉IMT的AUC分别为0.776、0.747,灵敏度分别为85.4%、64.6%,特异度分别为61.9%、78.6%;二者联合诊断的AUC为0.880,灵敏度为86.4%,特异度为79.6%。结论血浆NT-proBNP、NEU水平与高血压患者颈动脉IMT程度均密切相关,患者颈动脉IMT越厚,血浆NT-proBNP、NEU水平越高。血浆NT-proBNP联合NEU对高血压患者颈动脉IMT具有较高的预测价值。

Objective To analyze the correlation between plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),neutrophil(NEU)and carotid artery intima-media thickness(IMT)in patients with hypertension.Method A total of 90 patients with hypertension treated in the Second People's Hospital of Hefei from June 2017 to June 2020 were included in observation group.According to the IMT value of carotid artery,observation group patients was divided into three subgroups:normal group(IMT<0.9 mm,32 cases),thickened group(0.9 mm≤IMT<1.2 mm,31 cases)and plaque group(IMT≥1.2 mm,27 cases).In the same period,90 healthy people who underwent physical examination in that hospital were selected as control group.Systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NT-proBNP and NEU were observed and compared between the two groups.Pearson correlation analysis was used to investigate the correlation between plasma NT-proBNP,NEU levels and carotid artery IMT in patients with hypertension.Receiver operating characteristic curve(ROC curve)was plotted and the area under the curve(AUC)to evaluate the predictive value of plasma NT-proBNP and NEU levels on carotid artery IMT in patients with hypertension.Result The levels of SBP,TC,TG,LDL-C,NT-proBNP and NEU in observation group were significantly higher than those in control group(all P<0.05),and the level of HDL-C was significantly lower than that in control group(P<0.05).The levels of plasma NT-proBNP and NEU in plaque group and thickened group were significantly higher than those in normal group(all P<0.05),and the levels of plasma NT-proBNP and NEU in plaque group were significantly higher than those in thickened group(all P<0.05).Pearson correlation analysis showed that plasma NT-proBNP,NEU levels were positively correlated with carotid artery IMT in patients with hypertension(r=0.805,0.758,all P<0.001).The AUC of plasma NT-proBNP and NEU in predicting carotid artery IMT in hypertensive patients were 0.776 and 0.747,the sensitivity were 85.4%and 64.6%,the specificity were 61.9%and 78.6%,respectively.The AUC of combined diagnosis was 0.880,the sensitivity was 86.4%,and the specificity was 79.6%.Conclusion The levels of plasma NT-proBNP and NEU are closely related to the degree of carotid artery IMT in patients with hypertension.The thicker the carotid artery IMT in patients,the higher the levels of plasma NT-proBNP and NEU.Plasma NT-proBNP combined with NEU has a high predictive value for carotid artery IMT in patients with hypertension.