外周血髓过氧化物酶水平与高血压及颈动脉斑块形成的相关性分析

Correlation of peripheral blood MPO level with hypertension and carotid plaque formation

目的观察高血压患者外周血髓过氧化物酶(MPO)水平变化情况,探析其与高血压的发生、分级和颈动脉斑块形成之间的关联性。方法回顾性选取芜湖市第一人民医院2023年12月~2024年3月收治的198例高血压患者(高血压组),另选取同期198例健康人群进行对照研究(健康对照组)。通过测定外周血MPO水平,分析其与高血压的发生和颈动脉斑块形成之间的关联性。结果高血压患者外周血MPO水平为(15.33±4.25)ng/L,明显高于健康组的(10.47±2.28)ng/L,差异有统计学意义(t=14.190,P<0.05)。高血压1、2、3级患者之间外周血MPO水平分别为(13.10±3.06)ng/L、(16.03±3.24)ng/L、(20.30±4.29)ng/L,差异有统计学意义(F=59.954,P<0.05),3级患者MPO水平明显高于1、2级患者,差异有统计学意义(q=15.214、8.540,P<0.05),2级患者MPO水平明显高于1级患者,差异有统计学意义(q=7.767,P<0.05)。有颈动脉斑块形成高血压患者外周血MPO水平(17.99±4.17)ng/L,明显高于无颈动脉斑块形成患者(14.48±3.92)ng/L,差异有统计学意义(t=5.322,P<0.05)。Spearman相关性显示,外周血MPO水平与高血压发生、分级及颈动脉斑块形成均成正相关(r=0.612、0.587、0.351,P<0.05)。logistic回归分析显示,年龄、糖尿病、高脂血症、吸烟、饮酒、MPO水平是影响高血压发生的风险因素(OR=1.675、2.192、2.815、1.939、1.423、1.206、2.440,P<0.05),糖尿病、高脂血症、MPO水平是影响颈动脉斑块形成的风险因素(OR=1.902、2.065、2.818,P<0.05)。ROC曲线显示,外周血MPO水平评估高血压发生风险的AUC为0.853,敏感度为0.768,特异性为0.818,95%CI=0.815~0.891;评估高血压存在颈动脉斑块形成的AUC为0.736,敏感度为0.875,特异性为0.513,95%CI=0.660~0.813。结论外周血MPO水平与高血压发生及颈动脉斑块形成均存在一定的关联性,且对高血压发生及颈动脉斑块形成具有一定的评估价值。

Objective To observe the changes of myeloperoxidase(MPO)level in peripheral blood of patients with hypertension,and to explore and analyze its association with the the occurrence and grading of hypertension and carotid plaque formation.Methods From December 2023 to March 2024,198 patients with hypertension were retrospectively included in the study,and another 198 healthy people were selected for the control group.By measuring the level of MPO in peripheral blood,its association with hypertension occurrence and carotid plaque formation was analyzed.Results The level of MPO in peripheral blood of patients with hypertension was(15.33±4.25)ng∕L,which was significantly higher than that of the control group with(10.47±2.28)ng∕L(t=14.190,P<0.05).The difference was statistically significant in peripheral blood MPO level among patients with hypertension grade 1,2 and 3[(13.10±3.06)ng∕L vs.(16.03±3.24)ng∕L vs.(20.30±4.29)ng∕L](F=59.954,P<0.05).The level of MPO in patients with grade 3 was significantly higher than that in patients with grade 1 and grade 2(q=15.214,8.540,P<0.05),and the level of MPO was significantly higher in patients with grade 2 than that in patients with grade 1(q=7.767,P<0.05).The level of peripheral blood MPO was(17.99±4.17)ng∕L in hypertensive patients with carotid plaque formation,which was significantly higher than(14.48±3.92)ng∕L in patients without carotid plaque formation(t=5.322,P<0.05).Spearman correlation showed that the peripheral blood MPO level was positively correlated with the occurrence and grading of hypertension and carotid plaque formation(r=0.612,0.587,0.351,P<0.05).Logistic regression analysis revealed that age,diabetes mellitus,hyperlipidemia,smoking,drinking and MPO level were the risk factors for hypertension(OR=1.675,2.192,2.815,1.939,1.423,1.206,2.440,P<0.05),and diabetes mellitus,hyperlipidemia and MPO level were the risk factors for the formation of carotid plaque(OR=1.902,2.065,2.818,P<0.05).The ROC curve showed that the AUC of peripheral blood MPO levels for assessing the risk of developing hypertension was 0.853,with a sensitivity of 0.768,a specificity of 0.818,and a 95%CI=0.815~0.891,The AUC for assessing the progression of hypertension to grades 2 and 3 was 0.804,with a sensitivity of 0.822 and a specificity of 0.670,95%CI=0.745~0.864,and for assessing the presence of carotid plaque formation in hypertension was 0.736,with a sensitivity of 0.875 and a specificity of 0.513,95%CI=0.660~0.813.Conclusion There is a certain association between the level of peripheral blood MPO and the occurrence,grading and carotid plaque formation of hypertension,and it has certain evaluated value on the occurrence,progression and carotid plaque formation of hypertension.