部分炎性因子与老年原发性高血压患者血压昼夜节律改变的关系

Relationship between Some Inflammatory Factors and the Circadian Changes of Blood Pressure in Elderly Hypertensive Patients

目的研究部分炎性因子与老年原发性高血压(高血压)患者血压昼夜节律改变的关系。方法选取2020年3月至2021年3月在唐山市第三医院就诊的老年高血压患者165例,分为高血压组,根据不同血压昼夜节律变化类型分为杓形58例,非杓形60例,反杓形47例。选取同时期在本院健康体检的志愿者75名为对照组。实时荧光定量聚合酶链反应(polymerase chain reaction,PCR)检测肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、干扰素-γ(interferon-γ,IFN-γ)基因,全自动无创血压测量仪监测24 h动态血压[24 h平均舒张压(mean diastolic blood pressure,MDBP)、平均收缩压(mean systolic blood pressure,MSBP),白天MSBP、MDBP,夜间MSBP、MDBP]。结果高血压组患者IFN-γ(1.52±0.42 vs.1.03±0.27)、TNF-α(1.65±0.36 vs.1.06±0.31)、IL-6(1.19±0.27 vs.1.02±0.21)基因表达高于对照组,差异有统计学意义(P<0.05)。非杓形、反杓形患者夜间MDBP和夜间MSBP高于杓形;反杓形患者夜间MDBP和夜间MSBP高于非杓形,差异有统计学意义(P<0.05)。非杓形、反杓形患者的IFN-γ、TNF-α、IL-6基因表达高于杓形;反杓形患者IFN-γ、TNF-α、IL-6基因表达高于非杓形,差异有统计学意义(P<0.05)。IFN-γ、TNF-α、IL-6是引起老年高血压患者血压昼夜节律改变的危险因素(P<0.05)。结论非杓形、反杓形老年高血压患者血压昼夜节律改变异常,部分炎性因子表现明显,炎性因子为临床研究高血压发病机制提供指导价值。

Objectives The relationship of some inflammatory factors and circadian changes in blood pressure in elderly patients with hypertension was studied.Methods A total of 165 elderly hypertensive patients treated in Tangshan Third Hospital from March 2020 to March 2021 were divided into hypertension groups,including 58 arytenoid cases,60 nonarytenoid cases and 47 antiarytenoid cases according to different circadian change types of blood pressure.Seventy-five volunteers for health examination in our hospital during the same period were divided into control groups.Real-time polymerase chain reaction(PCR)was used to test tumor necrosis factor-γ(TNF-γ),interleukin-6(IL-6)and interferon-α(IFN-α)gene.Automatic non-invasive blood pressure meter monitored dynamic blood pressure for 24 h[24 h mean diastolic blood pressure(MDBP),meam systolic blood pressure(MSBP),daytime MSBP and MDBP,and nocturnal MSBP and MDBP].Results In hypertension group,the gene expressions of IFN-γ(1.52±0.42 vs.1.03±0.27),TNF-α(1.65±0.36 vs.1.06±0.31),IL-6(1.19±0.27 vs.1.02±0.21)were higher than those in control group(P<0.05).Nocturnal MDBP,nocturnal MSBP in patients with non-nocturnal hypertension,anti-arytenoid hypertension were higher than those in patients with arytenoid hypertension(P<0.05).Nocturnal MDBP,nocturnal MSBP in patients with antiarytenoid hypertension were higher than those in patients with non-arytenoid hypertension(P<0.05).Gene expressions of IFN-γ,TNF-α,and IL-6 in patients with non-nocturnal hypertension,anti-arytenoid hypertension were higher than those in patients with arytenoid hypertension(P<0.05).Gene expressions of IFN-γ,TNF-α,and IL-6 in patients with antiarytenoid hypertension were higher than that in patients with non-arytenoid hypertension(P<0.05).IFN-γ,TNF-α,and IL-6 were the risk factors for the altered circadian rhythm of blood pressure in elderly hypertensive patients(P<0.05).Conclusions In elderly patients with non-arytenoid and anti-arytenoid hypertension,abnormal circadian rhythm changes and some inflammatory factors provide guiding value for the clinical study of the pathogenesis of hypertension.