H型高血压患者血管超负荷指数、Cys C和血管内皮功能的相关性研究

Study on Relationship among Vascular Overload Index,Cystatin C and Vascular Endothelial Function in Patients with H-type Hypertension

目的:探讨H型高血压患者血管超负荷指数(vascular overload index,VOI)、血清胱抑素C(Cys C)和血管内皮功能的相关性。方法:选取2019年12月-2021年3月银川市第一人民医院心内科门诊和住院原发性高血压患者182例。根据同型半胱氨酸(Hcy)水平将182例患者分为H型高血压组(Hcy≥10μmol/L,86例)和单纯型高血压组(Hcy<10μmol/L,96例)。收集两组基线资料及用药情况,检测两组VOI,测定两组血管内皮功能,检测两组Hcy、Cys C水平。比较两组基线资料及用药情况。比较两组VOI及血管内皮功能、Hcy、Cys C水平。分析H型高血压患者VOI_(24 h)、VOI_(d)、VOI_(n)和血流介导血管内皮功能(FMD)、Cys C的相关性。分析H型高血压患者Cys C与Hcy、FMD的关系。结果:两组年龄、性别、吸烟史、体重指数(body massindex,BMI)、HR、SBP、DBP、血肌酐(Scr)、血尿素氮(BUN)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、病程比较差异均无统计学意义(P>0.05)。两组患者降压方案、他汀类药物、抗血小板药物比较差异无统计学意义(P>0.05)。H型高血压组VOI_(24 h)、VOI_(d)、VOI_(n)均高于单纯高血压组(P<0.05),单纯高血压组VOI_(24 h)最高,VOI_(d)高于VOI_(n);H型高血压组VOI_(24 h)最高,VOI_(d)低于VOI_(n)。两组D0比较差异无统计学意义(P>0.05),H型高血压组D1及FMD均明显低于单纯高血压组(P<0.05)。H型高血压组Cys C水平为(1.62±0.22)mg/L,高于单纯高血压组的(1.19±0.20)mg/L(t=2.021,P=0.000)。VOI_(24 h)、VOI_(d)、VOI_(n)与Cys C均呈正相关,与FMD均呈负相关(P<0.05)。Cys C与Hcy呈正相关(r=0.462,P<0.05),与FMD呈负相关(r=-0.421,P<0.05);Hcy与FMD呈负相关(r=-0.338,P<0.05)。结论:H型高血压患者VOI、Cys C和血管内皮功能密切相关。

Objective:To investigate the relationship among vascular overload index(VOI),cystatin C(Cys C)and vascular endothelial function in patients with H-type hypertension.Method:A total of 182 patients with essential hypertension were selected from the Department of Cardiology and Hospitalized in the First People’s Hospital of Yinchuan from December 2019 to March 2021.According to the level of homocysteine(Hcy),182 patients were divided into H-type hypertension group(Hcy≥10μmol/L,86cases)and simple hypertension group(Hcy<10μmol/L,96 cases).Baseline data and drug use condition of the two groups were collected,VOI,vascular endothelial function,Hcy and Cys C levels in the two groups were measured.Baseline data and drug use condition were compared between the two groups.The VOI,vascular endothelial function,Hcy and Cys C levels were compared between the two groups.The correlation of VOI_(24 h),VOI_(d),VOI_(n),and flow-mediated dilation(FMD),Cys C in patients with H-type hypertension was analyzed.The relationship between Cys C and Hcy,FMD in patients with H-type hypertension was analyzed.Result:There were no significant differences in age,sex,smoking history,body mass index(BMI),HR,SBP,DBP,blood creatinine(Scr),blood urea nitrogen(BUN),fasting blood glucose(FPG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),highdensity lipoprotein cholesterol(HDL-C)and course of disease between the two groups(P>0.05).There were no significant differences in depressurization scheme,statins and antiplatelet drug between the two groups(P>0.05).VOI_(24 h),VOI_(d)and VOI_(n)in H-type hypertension group were higher than those in simple hypertension group(P<0.05),and VOI_(24 h)in simple hypertension group was the highest,VOI_(d)was higher than VOI_(n).The VOI_(24 h)was the highest and VOI_(d)was lower than VOI_(n)in H-type hypertension group.There was no significant difference in D0 between the two groups(P>0.05),and D1 and FMD in H-type hypertension group were significantly lower than those in simple hypertension group(P<0.05).The level of Cys C in H-type hypertension group was(1.62±0.22)mg/L,which was higher than(1.19±0.20)mg/L in simple hypertension group(t=2.021,P=0.000).VOI_(24 h),VOI_(d)and VOI_(n)were positively correlated with Cys C,and negatively correlated with FMD(P<0.05).Cys C was positively correlated with Hcy(r=0.462,P<0.05),and negatively correlated with FMD(r=-0.421,P<0.05).Hcy was negatively correlated with FMD(r=-0.338,P<0.05).Conclusion:VOI and Cys C are significantly correlated with vascular endothelial function in patients with H-type hypertension.