中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2013年
4期
366-368
,共3页
原发性高血压%颈动脉斑块%血浆纤维蛋白原
原髮性高血壓%頸動脈斑塊%血漿纖維蛋白原
원발성고혈압%경동맥반괴%혈장섬유단백원
Essential hypertension%Carotid atherosclerotic plaques%Plasma fibrinogen
目的探讨原发性高血压（EH）患者颈动脉粥样硬化斑块及性质与血浆纤维蛋白原（FIB）的关系。方法纳入EH患者404例，根据是否合并颈动脉硬化斑块分为斑块组（n=235）和无斑块组（n=169），对两组受试者血浆纤维蛋白原（FIB）水平及斑块性质（分为软斑块、硬斑块、混合斑块）进行比较，并运用多因素回归分析对颈动脉粥样硬化斑块性质与血压、血脂、血糖、FIB关系进行研究。结果①斑块组FIB及低密度脂蛋白胆固醇（LDL-C）明显高于无斑块组[FIB：（3.92±2.82）g/L vs.（3.23±1.62）g/L，P=0.032；LDL-C：（3.23±0.91）mmol/L vs.（2.95±0.82）mmol/L，P=0.047]，而HDL-C低于无斑块组[（1.17±0.31）mmol/L vs.（1.25±0.35）mmol/L，P=0.021）；②软斑块组患者血浆FIB水平高于混合斑块[（4.18±2.89）g/L vs.（3.84±2.16） g/L，P＜0.05]和硬斑块[（4.18±2.89）g/L vs.（3.69±2.21）g/L，P＜0.05]，混合斑块与硬斑块患者之间无明显差异；③高FIB血症者颈动脉斑块检出率及软斑块比例均显著高于FIB正常者（74.7%vs.42.9%，P＜0.05；32.5%vs.8.1%，P＜0.05）；④多元回归分析发现血FIB水平、LDL-C与颈动脉斑块成正相关，HDL-C与颈动脉斑块成负相关。结论高血压患者血浆FIB水平与颈动脉斑块，尤其是软斑块密切相关。
目的探討原髮性高血壓（EH）患者頸動脈粥樣硬化斑塊及性質與血漿纖維蛋白原（FIB）的關繫。方法納入EH患者404例，根據是否閤併頸動脈硬化斑塊分為斑塊組（n=235）和無斑塊組（n=169），對兩組受試者血漿纖維蛋白原（FIB）水平及斑塊性質（分為軟斑塊、硬斑塊、混閤斑塊）進行比較，併運用多因素迴歸分析對頸動脈粥樣硬化斑塊性質與血壓、血脂、血糖、FIB關繫進行研究。結果①斑塊組FIB及低密度脂蛋白膽固醇（LDL-C）明顯高于無斑塊組[FIB：（3.92±2.82）g/L vs.（3.23±1.62）g/L，P=0.032；LDL-C：（3.23±0.91）mmol/L vs.（2.95±0.82）mmol/L，P=0.047]，而HDL-C低于無斑塊組[（1.17±0.31）mmol/L vs.（1.25±0.35）mmol/L，P=0.021）；②軟斑塊組患者血漿FIB水平高于混閤斑塊[（4.18±2.89）g/L vs.（3.84±2.16） g/L，P＜0.05]和硬斑塊[（4.18±2.89）g/L vs.（3.69±2.21）g/L，P＜0.05]，混閤斑塊與硬斑塊患者之間無明顯差異；③高FIB血癥者頸動脈斑塊檢齣率及軟斑塊比例均顯著高于FIB正常者（74.7%vs.42.9%，P＜0.05；32.5%vs.8.1%，P＜0.05）；④多元迴歸分析髮現血FIB水平、LDL-C與頸動脈斑塊成正相關，HDL-C與頸動脈斑塊成負相關。結論高血壓患者血漿FIB水平與頸動脈斑塊，尤其是軟斑塊密切相關。
목적탐토원발성고혈압（EH）환자경동맥죽양경화반괴급성질여혈장섬유단백원（FIB）적관계。방법납입EH환자404례，근거시부합병경동맥경화반괴분위반괴조（n=235）화무반괴조（n=169），대량조수시자혈장섬유단백원（FIB）수평급반괴성질（분위연반괴、경반괴、혼합반괴）진행비교，병운용다인소회귀분석대경동맥죽양경화반괴성질여혈압、혈지、혈당、FIB관계진행연구。결과①반괴조FIB급저밀도지단백담고순（LDL-C）명현고우무반괴조[FIB：（3.92±2.82）g/L vs.（3.23±1.62）g/L，P=0.032；LDL-C：（3.23±0.91）mmol/L vs.（2.95±0.82）mmol/L，P=0.047]，이HDL-C저우무반괴조[（1.17±0.31）mmol/L vs.（1.25±0.35）mmol/L，P=0.021）；②연반괴조환자혈장FIB수평고우혼합반괴[（4.18±2.89）g/L vs.（3.84±2.16） g/L，P＜0.05]화경반괴[（4.18±2.89）g/L vs.（3.69±2.21）g/L，P＜0.05]，혼합반괴여경반괴환자지간무명현차이；③고FIB혈증자경동맥반괴검출솔급연반괴비례균현저고우FIB정상자（74.7%vs.42.9%，P＜0.05；32.5%vs.8.1%，P＜0.05）；④다원회귀분석발현혈FIB수평、LDL-C여경동맥반괴성정상관，HDL-C여경동맥반괴성부상관。결론고혈압환자혈장FIB수평여경동맥반괴，우기시연반괴밀절상관。
Objective To investigate the relationship between level of plasma fibrinogen (FIB) and carotid atherosclerotic plaques in patients with essential hypertension (EH). Methods EH patients (n=454) were chosen and divided, according to whether or not they had complicated carotid atherosclerotic plaques, into plaque group (n=235) and non-plaque group (n=169). The level of plasma FIB and the properties of plaques (soft plaques, hard plaques and compound plaques) were compared between two groups. The properties of plaques and levels of blood pressure, blood fat, blood sugar and FIB were analyzed by using multi-factor regression. Results ①The levels of FIB and LDL-C were significantly higher in plaque group than that in non-plaque group [FIB:(3.92±2.82) g/L vs. (3.23±1.62) g/L, P=0.032;LDL-C:(3.23±0.91) mmol/L vs. (2.95±0.82) mmol/L, P=0.047], and level of HDL-C was lower in plaque group than that in non-plaque group [(1.17±0.31) mmol/L vs. (1.25±0.35) mmol/L, P=0.021)].②The level of plasma FIB was significantly higher in soft plaque group than that in compound plaque group [(4.18 ±2.89) g/L vs. (3.84±2.16) g/L, P<0.05] and hard plaque group [(4.18±2.89) g/L vs. (3.69±2.21) g/L, P<0.05]. There was no significant difference between compound plaque group and hard plaque group. ③The detection rate of carotid atherosclerotic plaques and proportion of soft plaques were significantly higher in the patients with hyperfibrinogenemia than those with normal FIB level (74.7%vs. 42.9%, P<0.05;32.5%vs. 8.1%, P<0.05). ④The multi-factor regression showed that carotid atherosclerotic plaques were positively correlated to the levels of FIB and LDL-C and negatively to the level of HDL-C. Conclusion The level of plasma FIB is closely related to carotid atherosclerotic plaques, especially to soft plaques in hypertensive patients.
