血清Lp(a)、CysC水平变化与原发性高血压患者血压分级的相关性

Correlation between the changes of serum Lp(a),Cys C levels and blood pressure classification in patients with essential hypertension

目的:探讨血清脂蛋白a[Lp(a)]胱抑素C(CysC)水平变化与原发性高血压(EH)患者血压分级的相关性。方法:选取我院2019年7月-2021年12月收治的148例EH患者为研究对象,根据高血压等级分级分为Ⅰ级组[57例,舒张压90~99 mmHg和(或)收缩压140~159 mmHg]、Ⅱ级组[49例,舒张压100~109 mmHg和(或)收缩压160~179 mmHg]、Ⅲ级组[42例,舒张压≥110mmHg和(或)收缩压大于等于180mmHg]。比较3组一般临床资料[性别、三酰甘油(TG)、年龄、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、总胆固醇(TC)、平均动脉压(MAP)、高密度脂蛋白胆固醇(HDL-C)、颈总动脉分叉前1 cm处的血管内膜中层厚度(cIMT)]入院时血清Lp(a)、CysC水平,分析血清Lp(a)、CysC与血压分级、cIMT的相关性,偏回归分析影响EH患者颈动脉内膜增厚的因素。结果:Ⅲ级组MAP、cIMT、Lp(a)、CysC水平>Ⅱ级组>Ⅰ级组(P<0.05);入院时血清Lp(a)、CysC水平与血压分级、cIMT呈正相关(P<0.05);Logistic回归分析显示,入院时血清Lp(a)水平(>307.74 mg/L)、CysC水平(>1.35mg/L)是EH患者发生颈动脉内膜增厚的危险因素(P<0.05)。结论:血清Lp(a)、CysC与EH密切相关,了解其水平变化对临床判断EH患者发生颈动脉内膜增厚风险具有指导意义。

Objective:To investigate the correlation between the changes of serum lipoprotein a[Lp(a],cystatin C(Cys C)levels and blood pressure grading in patients with essential hypertension(EH).Methods:148 EH patients admitted to our hospital from July 2019 to December 2021 were selected as research objects.According to the classification of hypertension,they were divided into Grade Ⅰ group(57 patients,diastolic blood pressure 90~99 mmHg and/or systolic blood pressure 140~159 mmHg),Grade Ⅱ group(49 patients,diastolic blood pressure 100~109 mmHg and/or systolic blood pressure 160~179 mmHg)and Grade Ⅲ group(42 patients,diastolic blood pressure≥110 mmHg and/or systolic blood pressure≥180 mmHg).The general clinical data(gender,triglyceride(TG),age,low density lipoprotein cholesterol(LDL-C),body mass index(BMI),total cholesterol(TC),mean arterial pressure(MAP),high density lipoprotein cholesterol(HDL-C),intima media thickness(cIMT)1 cm before the common carotid artery bifurcation),serum Lp(a),Cys Clevels at admission were compared among the three groups,and the correlation between serum Lp(a),Cys C and blood pressure classification,cIMT was analyzed,Partialregression analysis offactors affecting carotid intima thickening in EH patients.Results:Thelevels of MAP,cIMT,Lp(a)and Cys C in grade Ⅲ group were higher than those in grade Ⅱ group and higher than those in grade Ⅰ group(P<0.05);Serum Lp(a)and Cys Clevels at admission were positively correlated with blood pressure classification and cIMT(P<0.05);Logistic regression analysis showed that serum Lp(a)level(>307.74 mg/L)and Cys C level(>1.35 mg/L)at admission were risk factors for carotid intima thickening in EH patients(P<0.05).Conclusion:Serum Lp(a)and Cys C are closely related to EH It is instructive to understand the changes of serum Lp(a)and Cys Clevels to determine the risk of carotid intima thickening in EH patients.