中国冶金工业医学杂志

胱抑素\|C与原发性高血压患者心血管重构的相关性观察

作者：赵月妍朱维艳高飞

分类号：R 544.1

出版年,卷(期):页码：2015,32(4):373-375

摘要：

目的通过检测血清胱抑素\|C（Cys\|C）水平与原发性高血压病患者其左心室质量指数(left ventricular mass index，LVMI)、颈动脉内膜中层厚度（intima\|media thickness,IMT）关系观察其在原发性高血压患者心血管重构方面的作用。方法入选原发性高血压患者92例，1级27例，2级32例，3级33例。正常对照组24例。高血压组同时根据颈动脉硬化程度分为： IMT正常组（IMT＜0.9 mm）28例，IMT增厚组（IMT0.9~1.2 mm）20例和粥样斑块组（IMT≥1.2 mm）44例。检测一般生化指标：空腹血糖（FPG）、总胆固醇(TC)、低密度脂蛋白(LDL\|C)、高密度脂蛋白(HDL\|C)、甘油三酯(TG)、肾功（CRE）、Cys\|C。其他指标：体重指数(BMI)、收缩压(SBP)、舒张压(DBP)。通过彩色多普勒超声监测IMT及计算LVMI。结果（1）高血压组Cys\|C、IMT 、LVMI显著高于正常组（P＜0.01）。（2） Cys\|C在高血压患者组间比较有统计学差异，3级组高于2级、1级组（P＜0.05）。（3）Cys\|C随IMT升高而升高，斑块组与正常组比较存在明显统计学差异，P＜0.01。（4）相关性分析表明高血压患者的Cys\|C水平与IMT和LVMI明显正相关（P＜0.001）；影响IMT因素的多元线性回归分析显示，Cys\|C及SBP是影响IMT及LVMI的主要因素。结论Cys\|C与原发性高血压患者心血管重构密切相关。

关键词：高血压；胱抑素\|C；左心室质量指数；颈动脉内膜中层；心血管重构

ObjectiveTo detect serum cystatin\|C(Cys\|C)levels in patients with essential hypertension（EH）and analyze the correlation between Cys\|C and left ventricular mass index(LVMI),carotid intima\|media thickness(IMT),and observe its role in the reconstruction of cardiovascular in patients with EH.Methods92 patients with EH were selected,27 cases of stage Ⅰ,32 cases of stage Ⅱ,33 cases of stage Ⅲ.There were 24 patients in normal control group.According to the degree of carotid atherosclerosis,the patients in hypertension group were divided into IMT normal group(IMT＜0.9mm)(n=28),IMT thickening group(IMT 0.9~1.2mm)(n=20)and plaque group(IMT≥1.2mm)(n=44).General biochemical parameters were examined:fasting plasma glucose(FPG),total cholesterol(TC),low\|density lipoprotein(LDL\|C),high density lipoprotein(HDL\|C),triglycerides(TG),renal(CRE),Cys\|C.Other indicators were body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP).IMTs were monitored by color Doppler ultrasound and LVMIs were calculated.Results(1)Cys\|C,IMT,LVMI in hypertension group were significantly higher than that in normal group(P＜0.01).(2)Cys\|C among hypertension groups had relatively statistical difference,Cys\|C in stage Ⅲ group was significantly higher than that in stage Ⅱandstage Ⅰgroup(P＜0.05).(3).Cys\|C increased with IMTs,there were statistically significant difference in the plaque group and the normal group(P＜0.01).(4)Correlation analysis showed that Cys\|C levels in patients with hypertension was positively correlation with IMT and LVMI(P＜0.001); Multiple linear regression analysis of affecting IMT factors displayed that Cys\|C and SBP were the major factors affecting the IMT and LVMI.ConclusionCys\|C is closely correlated to the cardiovascular remodeling in patients with EH.Key Words:Hypertension；Cys\|C;Left ventricular mass index;IMT;Cardiovascular remodeling

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参考文献：

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