老年高血压患者HMGB1水平与血管内皮功能及动脉粥样硬化的相关性研究

Correlation of HMGB1 level with vascular endothelial function and atherosclerosis in elderly patients with hypertension

目的探讨老年原发性高血压(EH)患者高迁移率族蛋白1(HMGB1)水平与血管内皮功能及动脉粥样硬化的关系。方法选取佳木斯市中心医院2019年3月—2021年3月收治的老年EH患者及健康体检者各94例作为观察组与对照组,测量血流介导的血管舒张内径(FMD)、硝酸甘油介导的血管舒张内径(NMD)、颈动脉内—中膜厚度(IMT)、双侧斑块总数量(PN)、斑块总积分(PS)以及一氧化痰(NO)浓度。结果观察组高血压家族史(68.09%)、收缩压(165.97±14.82)mm Hg、舒张压(165.97±14.82)mm Hg、平均动脉压(123.86±12.70)mm Hg、脉压(65.68±15.79)mm Hg高于对照组[23.40%、(112.75±12.71)mm Hg、(73.53±5.89)mm Hg、(87.57±6.53)mm Hg、(41.75±8.57)mm Hg](P<0.05);观察组HMGB1(522.48±89.66)pg/mL、IMT平均值(0.86±0.13)mm、IMT最大值(0.92±0.11)mm、PN(0.41±0.76个)、PS(0.75±0.53个)高于对照组[(237.67±53.75)pg/mL、(0.51±0.21)mm、(0.62±0.24)mm、0个、0个];NO(29.67±6.57)μmol/L、肱动脉FMD(4.12±1.96)%低于对照组[(70.56±10.64)μmol/L、(13.77±2.58)%](P<0.05);HMBG1与收缩压(r=0.536)、舒张压(r=0.562)、平均动脉压(r=0.527)、脉压(r=0.518)、IMT平均值(r=0.547)、IMT最大值(r=0.513)、PS(r=0.522)呈正相关(P<0.001),与NO(r=-0.683)、FMD(r=-0.616)呈负相关(P<0.001);HMGB1(95%CI:4.237~5.724)、平均动脉压(95%CI:3.832~6.472)是FMD的独立影响因素(P<0.05);HMGB1(95%CI:1.852~4.842)、FMD(95%CI:2.174~6.649)、年龄(95%CI:1.283~3.281)、收缩压(95%CI:1.127~2.246)是IMT平均值的影响因素(P<0.05);HMGB1(95%CI:5.137~9.626)、吸烟史(95%CI:3.437~6.184)是PS的独立影响因素(P<0.05)。结论老年EH患者HMGB1水平升高是影响血管内皮及动脉粥样硬化的独立危险因素。

Objective To investigate the relationship between high mobility group protein 1(HMGB1)level and vascu⁃lar endothelial function and atherosclerotic lesions in elderly patients with hypertension.Methods Totally 94 elderly pa⁃tients with hypertension admitted from Mar 2019 to Mar 2021 and 94 physical examination healthy people were selected as observation group and control group.FMD,NMD,IMT,total plaque number(PN),total plaque integral(PS),and nitric oxide sputum(NO)concentration were measured.Results The family history of hypertension(68.09%),SBP(165.97±14.82mm Hg),DBP(165.97±14.82)mm Hg,MAP(123.86±12.70)mm Hg and PP(65.68±15.79)mm Hg in observation group were higher than in control group[23.40%,(112.75±12.71)mm Hg,(73.53±5.89)mm Hg,(87.57±6.53)mm Hg,(41.75±8.57)mm Hg](P<0.05).HMGB1(522.48±89.66)pg/mL,mean IMT(0.86±0.13)mm,maximum IMT(0.92±0.11)mm,PN(0.41±0.76)and PS(0.75±0.53)in observation group were higher than in control group[(237.67±53.75)pg/mL,(0.51±0.21)mm,(0.62±0.24)mm,0,0];while NO(29.67±6.57)μmol/L and FMD(4.12±1.96)%of brachial artery were lower than in the control group[(70.56±10.64)μmol/L,(13.77±2.58)%](P<0.05).HMBG1 was positively correlated with SBP,DBP,MAP,PP,mean IMT,maximum IMT and PS(r=0.536,0.562,0.527,0.518,0.547,0.513,0.522,P<0.001).There was negative correlation with NO and FMD(r=-0.683,-0.616,P<0.001).Multiple linear regression analysis showed that HMGB1(95%CI:4.237~5.724)and MAP(95%CI:3.832~6.472)were independent influencing factors of FMD(P<0.05).HMGB1(95%CI:1.852~4.842),FMD(95%CI:2.174~6.649),age(95%CI:1.283~3.281)and SBP(95%CI:1.127~2.246)were the independent influencing factors of mean IMT(P<0.05).HMGB1(95%CI:5.137~9.626)and smoking history(95%CI:3.437~6.184)were independent influ⁃encing factors of PS(P<0.05).Conclusion Elevated HMGB1 level is an independent risk factor for vascular endo⁃thelial and atherosclerosis in elderly patients with hypertension.