中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
10期
857-861
,共5页
高血压%动脉硬化%总抗氧化能力
高血壓%動脈硬化%總抗氧化能力
고혈압%동맥경화%총항양화능력
Hypertension%Atherosclerosis%Total antioxidant status
目的 观察老年原发性高血压患者血浆总抗氧化能力(total antioxidant status,TAS)水平变化；分析TAS相关因素；探讨老年高血压患者血浆TAS与肱-踝脉搏波传导速度(brachial-ankle pulsewave velocity,baPWV)的相关关系.方法 选取仁济医院老年病科体检和门诊年龄＞60岁患者225例,分为对照组(92例)和老年高血压组(133例),通过化学发光定量法检测其血浆TAS,同时测定超敏C反应蛋白(hsCRP)、尿微量白蛋白、血脂、血尿酸、血糖,利用彩色多普勒超声测定颈动脉内膜厚度(CIMT),并检测baPWV.结果 (1)老年高血压组血浆TAS水平显著低于对照组[分别为(1.123±0.126) mmol/L、(1.258 ±0.125) mmol/L,P＜0.05].在高血压组中高血压1、2和3级各组间TAS水平差异无统计学意义(P＞0.05).(2)TAS与心血管危险因素相关关系:多元逐步回归显示,hsCRP、血尿酸是影响TAS的独立因素(β=-0.03,标化β=-0.01,P＜0.05).(3)与对照组比较,老年高血压组baPWV明显增高,左侧baPWV(1914±341) cm/s比(1817±322) cm/s,右侧baPWV(1899±330) cm/s比(1772±345) cm/s(P＜0.05),且高血压组baPWV与血压水平呈正相关(P＜0.05)；(4)在校正年龄、hsCRP、血尿酸作偏相关分析结果显示老年高血压组血浆TAS仍与baPWV呈负相关(r=-0.459,P＜0.05).结论 老年高血压患者存在体内抗氧化能力降低,动脉僵硬度增加,抗氧化能力的下降可能参与动脉血管受损的过程,并与动脉弹性下降有关.
目的 觀察老年原髮性高血壓患者血漿總抗氧化能力(total antioxidant status,TAS)水平變化；分析TAS相關因素；探討老年高血壓患者血漿TAS與肱-踝脈搏波傳導速度(brachial-ankle pulsewave velocity,baPWV)的相關關繫.方法 選取仁濟醫院老年病科體檢和門診年齡＞60歲患者225例,分為對照組(92例)和老年高血壓組(133例),通過化學髮光定量法檢測其血漿TAS,同時測定超敏C反應蛋白(hsCRP)、尿微量白蛋白、血脂、血尿痠、血糖,利用綵色多普勒超聲測定頸動脈內膜厚度(CIMT),併檢測baPWV.結果 (1)老年高血壓組血漿TAS水平顯著低于對照組[分彆為(1.123±0.126) mmol/L、(1.258 ±0.125) mmol/L,P＜0.05].在高血壓組中高血壓1、2和3級各組間TAS水平差異無統計學意義(P＞0.05).(2)TAS與心血管危險因素相關關繫:多元逐步迴歸顯示,hsCRP、血尿痠是影響TAS的獨立因素(β=-0.03,標化β=-0.01,P＜0.05).(3)與對照組比較,老年高血壓組baPWV明顯增高,左側baPWV(1914±341) cm/s比(1817±322) cm/s,右側baPWV(1899±330) cm/s比(1772±345) cm/s(P＜0.05),且高血壓組baPWV與血壓水平呈正相關(P＜0.05)；(4)在校正年齡、hsCRP、血尿痠作偏相關分析結果顯示老年高血壓組血漿TAS仍與baPWV呈負相關(r=-0.459,P＜0.05).結論 老年高血壓患者存在體內抗氧化能力降低,動脈僵硬度增加,抗氧化能力的下降可能參與動脈血管受損的過程,併與動脈彈性下降有關.
목적 관찰노년원발성고혈압환자혈장총항양화능력(total antioxidant status,TAS)수평변화；분석TAS상관인소；탐토노년고혈압환자혈장TAS여굉-과맥박파전도속도(brachial-ankle pulsewave velocity,baPWV)적상관관계.방법 선취인제의원노년병과체검화문진년령＞60세환자225례,분위대조조(92례)화노년고혈압조(133례),통과화학발광정량법검측기혈장TAS,동시측정초민C반응단백(hsCRP)、뇨미량백단백、혈지、혈뇨산、혈당,이용채색다보륵초성측정경동맥내막후도(CIMT),병검측baPWV.결과 (1)노년고혈압조혈장TAS수평현저저우대조조[분별위(1.123±0.126) mmol/L、(1.258 ±0.125) mmol/L,P＜0.05].재고혈압조중고혈압1、2화3급각조간TAS수평차이무통계학의의(P＞0.05).(2)TAS여심혈관위험인소상관관계:다원축보회귀현시,hsCRP、혈뇨산시영향TAS적독립인소(β=-0.03,표화β=-0.01,P＜0.05).(3)여대조조비교,노년고혈압조baPWV명현증고,좌측baPWV(1914±341) cm/s비(1817±322) cm/s,우측baPWV(1899±330) cm/s비(1772±345) cm/s(P＜0.05),차고혈압조baPWV여혈압수평정정상관(P＜0.05)；(4)재교정년령、hsCRP、혈뇨산작편상관분석결과현시노년고혈압조혈장TAS잉여baPWV정부상관(r=-0.459,P＜0.05).결론 노년고혈압환자존재체내항양화능력강저,동맥강경도증가,항양화능력적하강가능삼여동맥혈관수손적과정,병여동맥탄성하강유관.
Objective To investigate the association between plasma total antioxidant status (TAS)and association with brachial-ankle pulsewave velocity (baPWV) in the elderly patients with essential hypertension(EH).Methods A total of 133 consecutive EH patients older than 60 years were enrolled and another 92 elderly non-EH healthy subjects served as control.According to blood pressure level,EH patients were further classified into three subgroups.The concentration of plasma total antioxidant status was measured by using chemical luminescence method.High-sensitive CRP,urine microalbumin,uric acid,blood lipids and blood glucose levels were also measured.Carotid intima-media thickness was determined by color Doppler ultrasonography and the degree of arteriosclerosis was investigated with baPWV and ankle-brachial index (ABI).Results (1) Plasma levels of TAS in EH patients were significant lower than in control group [(1.123 ± 0.126) mmol/L vs.(1.258 ± 0.125) mmol/L,P ＜ 0.05],and were similar among hypertension subgroups (P ＞ 0.05).(2) Stepwise multiple regression analysis showed that age,gender,body mass index,systolic blood pressure,diastolic blood pressure,high-sensitive CRP,UA were dependent variables of TAS.Multivariate regression analysis showed that high-sensitivity CRP,UA were independent factors affecting TAS (β =-0.03,standardized β =-0.01,P ＜ 0.05).(3) Compared with the control group,baPWV was significantly higher in elderly EH patients left baPWV(1914 ± 341)cm/s vs.(1817 ±322)cm/s,right baPWV (1899 ± 330) cm/s vs.(1772 ± 345) cm/s (P ＜ 0.05) and baPWV tended to increase with the level of blood pressure of EH group(P ＜ 0.05).(4) After adjusting for age,CRP,UA,partial correlation analysis showed that plasma TAS was negatively correlated with baPWV (r =-0.459,P ＜0.05).Conclusions Our results indicate that TAS and arterial elasticity are decreased while arterial stiffness is increased in elderly hypertensive patients.The decline in antioxidant capacity may be responsible for vascular damage and arterial elasticity decrease in elderly EH patients.
