CAJ | 학술논문

目的：对不同血压水平的特定人群进行心血管危险因子进行检测，以探讨心血管风险因素检测在心血管疾病中的诊断价值和在心血管疾病预防中的价值。方法限定一定条件，根据“中国高血压防治指南2010”将246例实验对象分为正常血压组（35例）、正常血压高值组（46例）、高血压1级组（52例）、高血压2级组（55例）、高血压3级组（58例），分别测定5组血清内皮素-1（ET-1）、高敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）水平并用超声检测颈动脉内膜中层厚度（IMT），分析不同血压组间各项指标的差异。结果2级和3级高血压组Hcy水平高于其他3组（P＜0．05）；且3级高血压组高于2级高血压组（P＜0．05）。3级高血压组hs-CRP水平高于其他4组（P＜0．05）；2级高血压组高于正常血压组、正常血压高值组（P＜0．05）；1级高血压组高于正常血压组（P＜0．05）。1、2和3级高血压组ET-1水平明显高于正常血压组、正常血压高值组（P＜0．05），且1、2和3级高血压各组间差异亦有统计学意义（P＜0．05）。3级高血压组IMT高于其他4组（P＜0．05），2级高血压组IMT高于正常血压组及正常血压高值组（P＜0．05）。随着收缩压的升高，ET-1、hs-CRP、Hcy、IMT的检测值也逐渐升高[相关系数（r）分别为0．302、0．214、0．192、0．285，P均＜0．05]；ET-1、hs-CRP、Hcy与IMT呈明显正相关（r值分别为0．358、0．249、0．226，P均＜0．05）。结论 ET-1、hs-CRP、Hcy水平及IMT与血压水平有很好的相关性。ET-1在反映血压变化中最为灵敏。为预防和延缓心血管危险事件的发生，应将 ET-1、hs-CRP、Hcy、IMT作为常规体检内容，特别是对于血压目前正常者。对于上述指标逐渐升高者更应引起注意。
목적：대불동혈압수평적특정인군진행심혈관위험인자진행검측，이탐토심혈관풍험인소검측재심혈관질병중적진단개치화재심혈관질병예방중적개치。방법한정일정조건，근거“중국고혈압방치지남2010”장246례실험대상분위정상혈압조（35례）、정상혈압고치조（46례）、고혈압1급조（52례）、고혈압2급조（55례）、고혈압3급조（58례），분별측정5조혈청내피소-1（ET-1）、고민C반응단백（hs-CRP）、동형반광안산（Hcy）수평병용초성검측경동맥내막중층후도（IMT），분석불동혈압조간각항지표적차이。결과2급화3급고혈압조Hcy수평고우기타3조（P＜0．05）；차3급고혈압조고우2급고혈압조（P＜0．05）。3급고혈압조hs-CRP수평고우기타4조（P＜0．05）；2급고혈압조고우정상혈압조、정상혈압고치조（P＜0．05）；1급고혈압조고우정상혈압조（P＜0．05）。1、2화3급고혈압조ET-1수평명현고우정상혈압조、정상혈압고치조（P＜0．05），차1、2화3급고혈압각조간차이역유통계학의의（P＜0．05）。3급고혈압조IMT고우기타4조（P＜0．05），2급고혈압조IMT고우정상혈압조급정상혈압고치조（P＜0．05）。수착수축압적승고，ET-1、hs-CRP、Hcy、IMT적검측치야축점승고[상관계수（r）분별위0．302、0．214、0．192、0．285，P균＜0．05]；ET-1、hs-CRP、Hcy여IMT정명현정상관（r치분별위0．358、0．249、0．226，P균＜0．05）。결론 ET-1、hs-CRP、Hcy수평급IMT여혈압수평유흔호적상관성。ET-1재반영혈압변화중최위령민。위예방화연완심혈관위험사건적발생，응장 ET-1、hs-CRP、Hcy、IMT작위상규체검내용，특별시대우혈압목전정상자。대우상술지표축점승고자경응인기주의。
Objective To detect the vascular risk factors in the subjects with different blood pressure,in order to investigate the significance of vascular risk factors in the diagnosis and prevention of cardiovascular diseases.Methods A total of 246 subjects were classified into normal blood pressure group(35 cases),normal blood pressure high value group(46 cases),grade 1 hypertension group (52 cases),grade 2 hypertension group (55 cases)and grade 3 hypertension group(58 cases)according to the Guidelines for the Prevention and Treatment of Hypertension in China 2010.Serum endothelin-1 (ET-1),high-sensitivity C-reactive protein (hs-CRP)and homocysteine (Hcy)were determined,and the carotid artery intima-media thickness (IMT)was measured by color ultrasound.The difference among the groups was analyzed.Results The Hcy levels of grade 2 and 3 hypertension groups were higher than those of the other 3 groups (P<0.05 ),and the Hcy level of grade 3 hypertension group was higher than that of grade 2 hypertension group (P<0.05).The hs-CRP level of grade 3 hypertension group was higher than those of the other 4 groups (P<0.05),the hs-CRP level of grade 2 hypertension group was higher than those of normal blood pressure and normal blood pressure high value groups (P<0.05 ),and the hs-CRP level of grade 1 hypertension group was higher than that of normal blood pressure group (P<0.05 ).The ET-1 levels of grade 1 ,2 and 3 hypertension groups were higher than those of normal blood pressure and normal blood pressure high value groups (P<0.05 ),and the ET-1 levels of grade 1,2 and 3 hypertension groups were significant statistically(P<0.05).The IMT detection results of grade 3 hypertension group were higher than those of the other 4 groups(P<0.05),and those of grade 2 hypertension group were higher than those of normal blood pressure and normal blood pressure high value groups (P<0.05).ET-1, hs-CRP,Hcy and IMT increased with systolic pressure,and the correlation coefficients(r)were 0.302,0.214,0.192 and 0.285 (P<0.05);ET-1,hs-CRP and Hcy had positive correlations with IMT (r=0.358,0.249 and 0.226,P<0.05).Conclusions There are good correlations among ET-1,hs-CRP and Hcy with IMT and corresponding blood pressure,and the ET-1 is the most sensitive in the progress of blood pressure change.ET-1 ,hs-CRP,Hcy and IMT should be used as routine physical examination parameters in order to prevent or stop cardiovascular risk.Especially,the subjects with normal blood pressure at present should be paid attention.