老年高血压合并冠心病患者血压晨峰与血清可溶性血管黏附因子1和干扰素γ相关性分析

Correlation between morning peak of blood pressure and serum sVCAM-1 and IFN-γin elderly patients with hypertension and coronary heart disease

目的:探究老年高血压合并冠心病患者血压晨峰(MBPP)与血清可溶性血管黏附因子-1(sVCAM-1)和干扰素-γ(IFN-γ)相关性。方法:以148例被确诊为高血压合并冠心病的老年患者为研究对象。监测其24 h血压波动,收集患者基本资料和血清指标。依据是否存在MBPP现象将患者分为非MBPP组和MBPP组。分析两组基本资料、血清指标、冠脉病变程度评分。结果:纳入148例患者中存在MBPP现象者78例,发生率为52.70%。与非MBPP组相比,MBPP组患者年龄明显增长,吸烟人数占比明显增加,血清甘油三酯(TG)、sVCAM-1、IFN-γ水平和Gensini积分明显升高(均P<0.05);白天、夜晚、全天24 h和晨峰收缩压值均明显升高(均P<0.05)。Pearson相关性分析显示,MBPP值与患者年龄、TG、sVCAM-1、IFN-γ和Gensini积分显著正相关(均P<0.05)。多元线性回归分析显示:患者年龄、吸烟年限、TG、sVCAM-1、IFN-γ、全天24 h收缩压和MBPP值均是老年高血压合并冠心病患者冠脉病变的独立危险因素(均P<0.05)。结论:老年高血压合并冠心病患者MBPP现象发生与血清sVCAM-1、IFN-γ高表达显著正相关。MBPP现象可能通过刺激机体sVCAM-1、IFN-γ高表达,放大机体炎症反应,加重患者冠脉病变程度。

Objective:To explore the correlation between the morning peak of blood pressure(MBPP)and the serum soluble vascular adhesion factor-1(sVCAM-1)and interferon-γ(IFN-γ)in elderly hypertensive patients with hypertension and coronary heart disease.Methods:148 elderly patients with hypertension and coronary heart disease were selected as research subjects.The 24-hour blood pressure fluctuation was monitored,and the basic data and serum indexes were collected and measured.According to whether there was MBPP phenomenon,patients were divided into non-MBPP group and MBPP group.The basic data,serum indexes,and coronary artery disease severity scores of the two groups were compared and analyzed.Results:78 of the 148 patients with MBPP phenomenon were included(52.70%).Compared with the non-MBPP group,the age of the patients in the MBPP group increased significantly,the proportion of smokers increased significantly,and the serum TG,sVCAM-1,IFN-γlevels and Gensini score were significantly increased(all P<0.05);the day,night,all day and morning peak systolic blood pressure increased significantly(all P<0.05).Pearson correlation analysis showed that the MBPP value was significantly positively correlated with patient’s age,TG,sVCAM-1,IFN-γand Gensini score(all P<0.05).Multiple linear regression analysis showed that the patient’s age,smoking years,TG,sVCAM-1,IFN-γ,24-hour systolic blood pressure and MBPP value were all independent risk factors for coronary artery disease in elderly patients with hypertension and coronary heart disease.Conclusion:The occurrence of MBPP in elderly patients with hypertension and coronary heart disease is significantly positively correlated with the high expression of serum sVCAM-1 and IFN-γ.MBPP may stimulate the body’s high expression of sVCAM-1 and IFN-γ,amplify the body’s inflammatory response,and aggravate the degree of coronary artery disease in patients.