CAJ | 학술논문

目的：探讨肝硬化患者中高血压病的患病率情况，以及肿瘤坏死因子（TNFα）、胆碱酯酶（CHE ）和 P物质、一氧化氮（NO）、肾上腺髓质素（ADM）在其中的作用和意义。方法病例组纳入2013年3月－2014年2月入院的肝硬化患者134例；对照组纳入268例健康体检者，分别采集空腹血液样本并测定血清中TNFα、CHE、P物质、NO和ADM的值，对2组有高血压病患者的患病率以及上述指标进行比较。计量资料比较采用t检验，计数资料用卡方检验，等级资料采用Kruskal－Wallis H检验。结果肝硬化患者的高血压病的患病率为18．66％（25/134），低于普通人群的患病率30．97％（83/268）。肝硬化伴高血压组的血清TNFα、P物质、NO、ADM水平均高于对照组有高血压病患者（t＝25．464、16．649、19．772、13．835，P值均＜0．05），而血清CHE水平肝硬化伴高血压组低于对照组有高血压病患者（t＝－50．257，P＜0．05）。结论肝硬化患者高血压病的患病率低于普通人群，肝硬化的患者高血压患病率低可能与肝硬化患者扩血管因素如血清中升高的P物质、NO、ADM增多有关。
목적：탐토간경화환자중고혈압병적환병솔정황，이급종류배사인자（TNFα）、담감지매（CHE ）화 P물질、일양화담（NO）、신상선수질소（ADM）재기중적작용화의의。방법병례조납입2013년3월－2014년2월입원적간경화환자134례；대조조납입268례건강체검자，분별채집공복혈액양본병측정혈청중TNFα、CHE、P물질、NO화ADM적치，대2조유고혈압병환자적환병솔이급상술지표진행비교。계량자료비교채용t검험，계수자료용잡방검험，등급자료채용Kruskal－Wallis H검험。결과간경화환자적고혈압병적환병솔위18．66％（25/134），저우보통인군적환병솔30．97％（83/268）。간경화반고혈압조적혈청TNFα、P물질、NO、ADM수평균고우대조조유고혈압병환자（t＝25．464、16．649、19．772、13．835，P치균＜0．05），이혈청CHE수평간경화반고혈압조저우대조조유고혈압병환자（t＝－50．257，P＜0．05）。결론간경화환자고혈압병적환병솔저우보통인군，간경화적환자고혈압환병솔저가능여간경화환자확혈관인소여혈청중승고적P물질、NO、ADM증다유관。
Objective To investigate the prevalence of hypertension in patients with liver cirrhosis and its relationship with tumor necrosis factor alpha (TNFα),cholinesterase (CHE),substance P (SP),nitric oxide (NO),and adrenomedullin (ADM).Methods A total of 134 cirrhotic patients newly admitted to the hospital were selected as case group,and 268 subjects undergoing physical examination were se-lected as control group.Fasting blood was collected,and serum levels of TNFα,CHE,SP,NO,and ADMwere determined.The two groups were compared with respect to the prevalence of hypertension and serum levels of TNFα,CHE,SP,NO,and ADM.Comparison of measure-ment data was made by t test,comparison of enumeration data was made by chi-square test,and comparison of ranked data was made by Kruskal-Wallis H test.Results The prevalence of hypertension for the case group (18.66%,25/134)was lower than that for the control group (30.97%,83/268).Among patients with hypertension,the case group had significantly higher serum levels of TNFα,SP,NO,and ADM(t=25.464,16.649,19.772,and 13.835,P<0.05 for all)but a significantly lower serum level of CHE (t=-50.257,P<0. 05 ),as compared with the control group.Conclusion Patients with liver cirrhosis has a lower prevalence of hypertension than the general population,which may be related to increases in serum vasodilating factors such as SP,NO,and ADM.