中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
36期
16-19
,共4页
高血压%脂联素%颈动脉%内膜中层厚度
高血壓%脂聯素%頸動脈%內膜中層厚度
고혈압%지련소%경동맥%내막중층후도
Hypertension%Adiponectin%Carotid arteries%Intima-media thickness
目的 探讨血清脂联素在原发性高血压(EH)发病中的作用及与颈动脉内膜中层厚度(IMT)的关系.方法 60例EH患者(EH组)和30例健康体检者(对照组)为研究对象,60例EH组患者根据《中国高血压防治指南(2005年)》中血压的分级标准分为三个亚组,1级EH组、2级EH组、3级EH组,每组20例.采用双抗体夹心ABC-酶联免疫吸附试验(ELISA)法检测血清脂联素水平,采用全自动生化仪测定血脂水平,采用彩色多普勒超声仪测定颈动脉IMT.结果 与对照组比较,EH组及1、2、3级EH组血清脂联素水平降低[(3.94±1.28)、(5.25±1.69)、(4.01±1.27)、(2.56±0.87)mg/L比(7.63±2.50) mg/L],颈动脉IMT增加[(1.30±0.42)、(0.94±0.30)、(1.32±0.44)、(1.65±0.51)mm比(0.69±0.22) mm],差异均有统计学意义(P＜0.05)；且EH各亚组间两两比较,随着血压水平升高,血清脂联素水平逐渐降低,颈动脉IMT逐渐增加,差异均有统计学意义(P＜0.05).与对照组比较,EH组及1、2、3级EH组血清TC、TG、LDL-C水平上升[TC:(6.53±2.09)、(5.14±1.66)、(6.59±2.20)、(7.86±2.42) mmol/L比(4.17±1.32)mmol/L;TG:(2.15±0.69)、(1.72±0.55)、(2.07±0.69)、(2.65±0.82) mmol/L比(1.38±0.44) mmol/L; LDL-C:(3.78±1.21)、(3.12±1.01)、(3.74±1.25)、(4.48±1.38)mmol/L比(2.46 ±0.78) mmol/L],HDL-C水平下降[(0.96±0.31)、(1.39±0.45)、(0.85±0.28)、(0.64 ±0.20) mmol/L比(1.69±0.54) mmol/L],差异均有统计学意义(P＜0.05)；且EH各亚组间两两比较,随着血压水平升高,血清TC、TG、LDL-C水平上升,HDL-C水平下降,差异均有统计学意义(P＜0.05).血清脂联素水平与颈动脉IMT呈显著负相关(r=-0.435,P＜0.01),与血脂(TC、TG、LDL-C、HDL-C)水平有相关性(P＜0.01).结论 脂联素在EH的发生和发展过程中起着重要作用,并与颈动脉IMT的增厚和血脂代谢紊乱密切相关,顽固性EH患者增加降血脂药物可能会提高降血压治疗的疗效.
目的 探討血清脂聯素在原髮性高血壓(EH)髮病中的作用及與頸動脈內膜中層厚度(IMT)的關繫.方法 60例EH患者(EH組)和30例健康體檢者(對照組)為研究對象,60例EH組患者根據《中國高血壓防治指南(2005年)》中血壓的分級標準分為三箇亞組,1級EH組、2級EH組、3級EH組,每組20例.採用雙抗體夾心ABC-酶聯免疫吸附試驗(ELISA)法檢測血清脂聯素水平,採用全自動生化儀測定血脂水平,採用綵色多普勒超聲儀測定頸動脈IMT.結果 與對照組比較,EH組及1、2、3級EH組血清脂聯素水平降低[(3.94±1.28)、(5.25±1.69)、(4.01±1.27)、(2.56±0.87)mg/L比(7.63±2.50) mg/L],頸動脈IMT增加[(1.30±0.42)、(0.94±0.30)、(1.32±0.44)、(1.65±0.51)mm比(0.69±0.22) mm],差異均有統計學意義(P＜0.05)；且EH各亞組間兩兩比較,隨著血壓水平升高,血清脂聯素水平逐漸降低,頸動脈IMT逐漸增加,差異均有統計學意義(P＜0.05).與對照組比較,EH組及1、2、3級EH組血清TC、TG、LDL-C水平上升[TC:(6.53±2.09)、(5.14±1.66)、(6.59±2.20)、(7.86±2.42) mmol/L比(4.17±1.32)mmol/L;TG:(2.15±0.69)、(1.72±0.55)、(2.07±0.69)、(2.65±0.82) mmol/L比(1.38±0.44) mmol/L; LDL-C:(3.78±1.21)、(3.12±1.01)、(3.74±1.25)、(4.48±1.38)mmol/L比(2.46 ±0.78) mmol/L],HDL-C水平下降[(0.96±0.31)、(1.39±0.45)、(0.85±0.28)、(0.64 ±0.20) mmol/L比(1.69±0.54) mmol/L],差異均有統計學意義(P＜0.05)；且EH各亞組間兩兩比較,隨著血壓水平升高,血清TC、TG、LDL-C水平上升,HDL-C水平下降,差異均有統計學意義(P＜0.05).血清脂聯素水平與頸動脈IMT呈顯著負相關(r=-0.435,P＜0.01),與血脂(TC、TG、LDL-C、HDL-C)水平有相關性(P＜0.01).結論 脂聯素在EH的髮生和髮展過程中起著重要作用,併與頸動脈IMT的增厚和血脂代謝紊亂密切相關,頑固性EH患者增加降血脂藥物可能會提高降血壓治療的療效.
목적 탐토혈청지련소재원발성고혈압(EH)발병중적작용급여경동맥내막중층후도(IMT)적관계.방법 60례EH환자(EH조)화30례건강체검자(대조조)위연구대상,60례EH조환자근거《중국고혈압방치지남(2005년)》중혈압적분급표준분위삼개아조,1급EH조、2급EH조、3급EH조,매조20례.채용쌍항체협심ABC-매련면역흡부시험(ELISA)법검측혈청지련소수평,채용전자동생화의측정혈지수평,채용채색다보륵초성의측정경동맥IMT.결과 여대조조비교,EH조급1、2、3급EH조혈청지련소수평강저[(3.94±1.28)、(5.25±1.69)、(4.01±1.27)、(2.56±0.87)mg/L비(7.63±2.50) mg/L],경동맥IMT증가[(1.30±0.42)、(0.94±0.30)、(1.32±0.44)、(1.65±0.51)mm비(0.69±0.22) mm],차이균유통계학의의(P＜0.05)；차EH각아조간량량비교,수착혈압수평승고,혈청지련소수평축점강저,경동맥IMT축점증가,차이균유통계학의의(P＜0.05).여대조조비교,EH조급1、2、3급EH조혈청TC、TG、LDL-C수평상승[TC:(6.53±2.09)、(5.14±1.66)、(6.59±2.20)、(7.86±2.42) mmol/L비(4.17±1.32)mmol/L;TG:(2.15±0.69)、(1.72±0.55)、(2.07±0.69)、(2.65±0.82) mmol/L비(1.38±0.44) mmol/L; LDL-C:(3.78±1.21)、(3.12±1.01)、(3.74±1.25)、(4.48±1.38)mmol/L비(2.46 ±0.78) mmol/L],HDL-C수평하강[(0.96±0.31)、(1.39±0.45)、(0.85±0.28)、(0.64 ±0.20) mmol/L비(1.69±0.54) mmol/L],차이균유통계학의의(P＜0.05)；차EH각아조간량량비교,수착혈압수평승고,혈청TC、TG、LDL-C수평상승,HDL-C수평하강,차이균유통계학의의(P＜0.05).혈청지련소수평여경동맥IMT정현저부상관(r=-0.435,P＜0.01),여혈지(TC、TG、LDL-C、HDL-C)수평유상관성(P＜0.01).결론 지련소재EH적발생화발전과정중기착중요작용,병여경동맥IMT적증후화혈지대사문란밀절상관,완고성EH환자증가강혈지약물가능회제고강혈압치료적료효.
Objective To investigate the changes of serum adiponectin (APN) levels in patients with essential hypertension (EH) and the correlation with carotid artery intima-media thickness (IMT).Methods Sixty patients with EH(EH group) and 30 healthy people (control group) were studied,the EH patients were divided into 3 subgroups with 20 cases each according to the standard of China guideline for hypertension prevention and control (2005).The serum APN level was detected by double antibody sandwich ABC enzyme-linked immunosorbent assay,the blood lipids levels [total cholesterol (TC),triglyeride (TG),low density lipoprotein-cholesterol (LDL-C) and highdensity lipoprotein-cholesterol (HDL-C)]were detected by automatic biochemical analyzer,and the carotid artery IMT was detected by color Doppler ultrasonography.Results The serum APN levels and carotid artery IMT in EH group and 1,2,3 subgroup were significant differences compared with those in control group [(3.94 ± 1.28),(5.25 ± 1.69),(4.01 ±1.27),(2.56 ± 0.87) mg/L vs.(7.63 ± 2.50) mg/L; (1.30 ± 0.42),(0.94 ± 0.30),(1.32 ± 0.44),(1.65 ±0.51)mm vs.(0.69 ± 0.22) mm,P ＜ 0.05].The comparison between two subgroups,along with elevated blood pressure levels,APN levels gradually decreased,and carotid artery IMT gradually increased (P ＜0.05).The serum TC,TG,LDL-C and HDL-C levels in EH group and 1,2,3 subgroup were significant differences compared with those in control group [TC:(6.53 ± 2.09),(5.14 ± 1.66),(6.59 ± 2.20),(7.86 ±2.42) mmol/L vs.(4.17 ± 1.32) mmool/L;TG:(2.15 ± 0.69),(1.72 ± 0.55),(2.07 ± 0.69),(2.65 ± 0.82)mmol/L vs.(1.38 ±0.44) mmol/L;LDL-C:(3.78 ± 1.21),(3.12 ± 1.01),(3.74 ± 1.25),(4.48 ± 1.38)mmol/L vs.(2.46 ±0.78) mmol/L;HDL-C:(0.96 ±0.31),(1.39 ±0.45),(0.85 ±0.28),(0.64 ±0.20)mmol/L vs.(1.69 ± 0.54) mmol/L,P ＜ 0.05].The comparison between two subgroups,along with elevated blood pressure levels,TC,TG and LDL-C levels gradually increased,and HDL-C gradually decreased (P ＜0.05).There was negative correlation between the serum APN level and carotid artery IMT (r =-0.435,P＜0.01),and there was correlation between the serum APN level and blood lipids levels (TC,TG,LDL-C and HDL-C) (P ＜ 0.01).Conclusions The APN plays an important role in the occurrence and development of EH,it is closely related to the carotid artery IMT thickening and lipid metabolism disorders.Increasing the lipid-lowering drugs may improve the efficacy of antihypertensive therapy in patients with resistant EH.
