冠心病合并微量白蛋白尿患者中心动脉压与颈动脉粥样硬化及Vaspin水平的研究

Study on the relationship between central aortic pressure, carotid atherosclerosis and the Vaspin level of the patients with coronary heart disease combined with microalbuminuria

目的探讨冠心病合并微量白蛋白尿患者的中心动脉压与颈动脉粥样硬化及血清脂肪特异性丝氨酸蛋白酶抑制剂水平的关系,旨在能够早期发现高血压病的亚临床靶器官损害,为心血管疾病的及时诊断及治疗提供新的思路。方法入选的冠心病患者于冠脉造影时测量中心动脉压并行颈动脉超声检查,同时进一步检测尿微量白蛋白。将136例阳性患者据颈动脉超声结果分为斑块组(n=85)与非斑块组(n=51),比较2组的中心动脉血压及血清脂肪特异性丝氨酸蛋白酶抑制剂水平;另将尿微量白蛋白阳性患者据中心动脉脉压分为宽脉压组(n=82)及非宽脉压组(n=54),比较其颈动脉硬化程度及血清脂肪特异性丝氨酸蛋白酶抑制剂水平。结果冠心病合并微量白蛋白尿患者中心动脉血压及颈动脉硬化程度显著增高(P<0.05);颈动脉斑块组中心动脉收缩压及脉压高于非斑块组,脂肪特异性丝氨酸蛋白酶抑制剂水平低于非斑块组(P<0.05);宽脉压组颈动脉内中膜厚度、斑块检出率、斑块厚度及斑块面积均高于非宽脉压组,脂肪特异性丝氨酸蛋白酶抑制剂水平低于非宽脉压组(P<0.05)。结论冠心病合并微量白蛋白尿患者中心动脉压及颈动脉粥样硬化程度与脂肪特异性丝氨酸蛋白酶抑制剂呈负相关,其血清水平可以作为一个预测指标,为今后研究和治疗冠心病及相关疾病提供新的思路。

Objective To detect subclinical target organ damage in hypertension on early stage,so as to provide new ideas for timely diagnosis and treatment of cardiovascular diseases by exploring the relationship between central aortic pressure,carotid atherosclerosis and the Vaspin level of the patients with coronary heart disease(CHD)combined with microalbuminuria.Methods The central aortic pressure of the patients with CHD enrolled in the study were measured while carotid ultrasound and coronary angiography were performed,and the urinary albumin was detected.A total of 136 positive patients were divided into plaque group(n=85)and non-plaque group(n=51)according to carotid ultrasound examination results.The central arterial blood pressure and Vaspin levels of patients in both groups were compared.Moreover,the positive patients were divided into wide pulse pressure group(n=82)and non-wide pulse pressure group(n=54)according to the central artery pulse pressure.The degree of carotid atherosclerosis and Vaspin level of the patients in both groups were compared.Results The central arterial blood pressure and the degree of carotid atherosclerosis of the patients with CHD combined with microalbuminuria were significantly increased(P<0.05).The central aortic systolic blood pressure(CSP)and pulse pressure(CPP)of the patients in plaque group were higher than those in non-plaque group.And the Vaspin levels were lower than those in non-plaque group(P<0.05).Moreover,the thickness of carotid intima-media,plaque detection rate,plaque thickness and plaque area in wide pulse pressure group were higher than those in non-wide pulse pressure group.And the Vaspin levels were lower than those in non-wide pulse pressure group(P<0.05).Conclusion The CSP and the degree of carotid atherosclerosis of the patients with CHD combined with microalbuminuria are negatively correlated with Vaspin,and the serum levels can regarded as a predictive index to provide an new idea for future research and treatment of CHD and related diseases.