CAJ | 학술논문

目的探讨血浆C反应蛋白水平与血压昼夜波动程度的关系. 方法入选高血压患者82例,正常血压者79例.采用免疫荧光色谱法检测血浆超敏C反应蛋白水平,同时用24 h动态血压仪监测入选者血压水平和血压变异性.采用多元线性回归,校正年龄、性别、体质指数、血糖、血脂、吸烟史、基线血压等各影响因素,分析C反心蛋白水平与血压昼夜波动的关系. 结果 (1)高血压组白天、夜间和24 h收缩压变异性均高于对照组(P＜0.01、P＜0.01和P＜0.05),舒张压变异性亦高于对照组(均为P＜0.05),而夜间收缩压、舒张压和平均动脉压下降率均低于对照组(分别为P＜0.01、P＜0.05和P＜0.05);(2)高血压组血浆C反应蛋白高于对照组分别为(5.44±1.78)mg/L与(3.03±0.72)mg/L,差异有统计学意义(P＜0.01);(3)高血压组白天、夜间和24 h 3个时段的舒张压变异性均与C反应蛋白水平呈正相关(分别为r=0.492,P＜0.001;r=0.240,P=0.048;r=0.271,P=0.030).多元线性回归分析结果显示,上述3个时段的舒张压变异性对C反应蛋白水平具有预测作用(r=0.660,决定系数R2=0.436;回归模型F=11.597,P＜0.001).(4)正常血压组各时段的血压变异性与C反应蛋白水平无相关性. 结论高血压患者血压变异性、血浆C反应蛋白水平均显著高于正常血压患者,而夜间血压下降率低于正常血压者,且高血压患者血浆C反应蛋白水平与昼夜血压的波动程度,特别是舒张压的波动程度密切相关.
목적 탐토혈장C반응단백수평여혈압주야파동정도적관계. 방법입선고혈압환자82례,정상혈압자79례.채용면역형광색보법검측혈장초민C반응단백수평,동시용24 h동태혈압의감측입선자혈압수평화혈압변이성.채용다원선성회귀,교정년령、성별、체질지수、혈당、혈지、흡연사、기선혈압등각영향인소,분석C반심단백수평여혈압주야파동적관계. 결과 (1)고혈압조백천、야간화24 h수축압변이성균고우대조조(P＜0.01、P＜0.01화P＜0.05),서장압변이성역고우대조조(균위P＜0.05),이야간수축압、서장압화평균동맥압하강솔균저우대조조(분별위P＜0.01、P＜0.05화P＜0.05);(2)고혈압조혈장C반응단백고우대조조분별위(5.44±1.78)mg/L여(3.03±0.72)mg/L,차이유통계학의의(P＜0.01);(3)고혈압조백천、야간화24 h 3개시단적서장압변이성균여C반응단백수평정정상관(분별위r=0.492,P＜0.001;r=0.240,P=0.048;r=0.271,P=0.030).다원선성회귀분석결과현시,상술3개시단적서장압변이성대C반응단백수평구유예측작용(r=0.660,결정계수R2=0.436;회귀모형F=11.597,P＜0.001).(4)정상혈압조각시단적혈압변이성여C반응단백수평무상관성. 결론고혈압환자혈압변이성、혈장C반응단백수평균현저고우정상혈압환자,이야간혈압하강솔저우정상혈압자,차고혈압환자혈장C반응단백수평여주야혈압적파동정도,특별시서장압적파동정도밀절상관.
Objective To explore the association between CRP and circadian variation of blood pressure in both hypertensive and normotensive old population.Methods The 82 patients with essential hypertension (EH) and 79 normotensive adults were enrolled in this study. Serum high sensitive CRP (hsCRP) level was tested by fluorescence immunoassay technology. The 24-hour ambulatory monitor of the level and variability of blood pressure was carried out. Multivariable linear regression models were run to adjust the age, gender, body mass index, blood sugar, blood fat,smoking history and baseline blood pressure for analyzing the association between hsCRP and circadian variation of blood pressure.Results ( 1 ) The variability of systolic blood pressure during daytime,nighttime and 24-h our periods were higher in EH group than in control group (P＜0.01 or P＜0. 05), the variabilities of diastolic blood pressure were also significantly higher than in control group (P＜0. 05), the dipping ratios of nocturnal systolic, diastolic and mean artery pressure were all less than in contrast group (all P＜0.05). (2) The hsCRP was obviously higher in EH group than in control group [(5.44± 1.78)mg/L vs. (3.03±0. 72) mg/L, P＜0. 01]. (3) The hsCRP had positive associations with diastolic blood pressure variability during daytime (r= 0. 492, P＜0. 001 ), nighttime (r=0.240, P=0.048), and 24-hour (r=0.271, P=0.030). The variability in diastolic blood pressure predic ted the level of hs CRP(r=0.660, R2=0.436, P＜0.001). (4) In control group, no significant association was found between CRP and variation of blood pressure.Conclusions The BP variability and serum CRP in EH patients are obviously higher than in normotensive patients,however, the nocturnal BP dipping ratio is less than in normotensive patients. Furthermore, the level of serum hsCRP in EH patients is positively associated with the variation of blood pressure, especially for variation of diastolic blood pressure.