原发性高血压患者血压变异性与炎症标志物及颈动脉粥样硬化程度的相关性分析

Correlation among blood pressure variability,inflammatory markers and carotid atherosclerosis severity in patients with primary hypertension

目的探讨原发性高血压患者血压变异性(BPV)与炎症标志物及颈动脉粥样硬化程度的关系。方法入选2018年9月至2020年9月于郑州大学第二附属医院就诊的原发性高血压患者136例,根据收缩压(SBP)昼夜节律分为杓型组(44例)、非杓型组(56例)和反杓型组(36例),收集相关指标值,分析BPV与炎症标志物及颈动脉粥样硬化程度间的关系。结果反杓型与非杓型组炎症标志物较杓型组高,差异有统计学意义(P<0.05);反杓型组颈动脉粥样硬化斑块形成检出率高于杓型组与非杓型组,差异有统计学意义(P<0.05);Pearson相关分析示,炎症标志物、颈动脉粥样硬化程度与晚间平均收缩压(nSBP)存在显著相关性(r=0.2~0.5,P<0.05);超敏C反应蛋白(hs-CRP)与BPV负相关(r=0.2~0.5,P<0.01);白细胞介素-6(IL-6)与BPV正相关(r=0.2~0.3,P<0.05)。结论原发性高血压患者BPV、nSBP与炎症标志物及颈动脉粥样硬化有相关性,提示机体通过炎症机制使血管发生相应改变继而影响血压,使血压下降率异常,促进靶器官损伤。

Objective To discuss the relationship among blood pressure variability(BPV),inflammatory markers and severity of carotid atherosclerosis(CAS)in patients with primary hypertension(PH).Methods PH patients(n=136)were chosen from the Second Affiliated Hospital of Zhengzhou University from Sept.2018 to Sept.2020,and they were divided,according to circadian rhythm of systolic blood pressure(SBP),into dipper hypertension group(n=44),non-dipper hypertension group(n=56)and reverse-dipper hypertension group(n=36).The relative indexes were collected,and relationship among BPV,inflammatory markers and CAS severity were analyzed.Results The levels of inflammatory markers were higher in reverse-dipper hypertension group and non-dipper hypertension group than those in dipper hypertension group(P<0.05).The detection rate of CAS plaque was higher in reverse-dipper hypertension group than that in dipper hypertension group and non-dipper hypertension group(P<0.05).The results of Pearson correlation analysis showed that inflammatory markers and CAS severity were significantly correlated to nighttime mean systolic pressure(n-MSP,r=0.2-0.5,P<0.05).The level of high sensitivity C-reactive protein(hs-CRP)was negatively correlated to BPV(r=0.2-0.3,P<0.01),and level of interleukin-6(IL-6)was positively correlated to BPV(r=0.2-0.3,P<0.05).Conclusion BPV,n-MSP and inflammatory markers are correlated to CAS in PH patients,which indicates that blood vessels have corresponding changes through inflammatory mechanism,and further affect blood pressure inducing abnormal blood pressure drop rate and promoting target organ damage.