CAJ | 학술논문

目的：探讨新疆维吾尔族、汉族原发性高血压病患者颈动脉内膜中层厚度（ IMT）与血清胱抑素 C （Cys - C）水平的关系。方法回顾性分析2012年11月—2014年3月在新疆医科大学第一附属医院心脏中心高血压科住院的494例原发性高血压病患者的病历资料，其中维吾尔族197例，汉族297例。根据颈动脉 IMT 分组，将维吾尔族患者分为正常组100例和异常组97例，汉族患者分为正常组179例和异常组118例。收集患者入院时一般资料，检测并比较 IMT 正常与异常患者生化指标〔空腹血糖、Cys - C、三酰甘油、总胆固醇、高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）〕、颈动脉 IMT 及动态血压〔24 h 平均收缩压（24 hSBP）、24 h 平均舒张压（24 hDBP）〕。结果维吾尔族患者中，正常组与异常组年龄、Cys - C、24 hSBP比较，差异有统计学意义（P ＜0.05）。汉族患者中，正常组与异常组年龄、Cys - C比较，差异有统计学意义（ P ＜0.05）。维吾尔族患者中，年龄、空腹血糖、Cys - C、24 hSBP与颈动脉 IMT 呈正相关（P ＜0.05）；进一步校正年龄、空腹血糖、24 hSBP后，Cys - C仍与颈动脉 IMT 呈正相关（r ＝0.217，P ＝0.010）。汉族患者中，年龄、体质指数、24 hSBP与颈动脉 IMT 呈正相关， Cys - C与颈动脉 IMT 呈负相关（P ＜0.05）；进一步校正年龄、体质指数、24 hSBP后，Cys - C仍与颈动脉 IMT 呈负相关（r ＝-0.163，P ＝0.038）。多因素 Logistic 回归分析结果显示，年龄、Cys - C是维吾尔族患者颈动脉 IMT 的影响因素，年龄是汉族患者颈动脉 IMT 的影响因素（P ＜0.05）。结论血清Cys - C水平升高是维吾尔族原发性高血压病患者颈动脉 IMT 增加的危险因素，而可能与汉族原发性高血压病患者颈动脉 IMT 无关。
목적：탐토신강유오이족、한족원발성고혈압병환자경동맥내막중층후도（ IMT）여혈청광억소 C （Cys - C）수평적관계。방법회고성분석2012년11월—2014년3월재신강의과대학제일부속의원심장중심고혈압과주원적494례원발성고혈압병환자적병력자료，기중유오이족197례，한족297례。근거경동맥 IMT 분조，장유오이족환자분위정상조100례화이상조97례，한족환자분위정상조179례화이상조118례。수집환자입원시일반자료，검측병비교 IMT 정상여이상환자생화지표〔공복혈당、Cys - C、삼선감유、총담고순、고밀도지단백담고순（HDL - C）、저밀도지단백담고순（LDL - C）〕、경동맥 IMT 급동태혈압〔24 h 평균수축압（24 hSBP）、24 h 평균서장압（24 hDBP）〕。결과유오이족환자중，정상조여이상조년령、Cys - C、24 hSBP비교，차이유통계학의의（P ＜0.05）。한족환자중，정상조여이상조년령、Cys - C비교，차이유통계학의의（ P ＜0.05）。유오이족환자중，년령、공복혈당、Cys - C、24 hSBP여경동맥 IMT 정정상관（P ＜0.05）；진일보교정년령、공복혈당、24 hSBP후，Cys - C잉여경동맥 IMT 정정상관（r ＝0.217，P ＝0.010）。한족환자중，년령、체질지수、24 hSBP여경동맥 IMT 정정상관， Cys - C여경동맥 IMT 정부상관（P ＜0.05）；진일보교정년령、체질지수、24 hSBP후，Cys - C잉여경동맥 IMT 정부상관（r ＝-0.163，P ＝0.038）。다인소 Logistic 회귀분석결과현시，년령、Cys - C시유오이족환자경동맥 IMT 적영향인소，년령시한족환자경동맥 IMT 적영향인소（P ＜0.05）。결론혈청Cys - C수평승고시유오이족원발성고혈압병환자경동맥 IMT 증가적위험인소，이가능여한족원발성고혈압병환자경동맥 IMT 무관。
Objective To investigate the relationship between carotid intima - media thickness(IMT)and Cystatin C (Cys - C)level in Uygur and Han patients with essential hypertension. Methods We made a retrospective analysis of the data of the medical history of 494 patients who were admitted into the Department of Hypertension of the First Affiliated Hospital of Xinjiang Medical University from December 2012 to March 2014. Among the patients,197 were Uygur and 297 were Han. According to the classification of carotid IMT,Uygur patients were divided into normal group(n = 100)and abnormal group (n = 97),and Han peoples were also divided into normal group(n = 179)and abnormal group(n = 118). The general data of the patients were collected at admission,and the biochemical indexes〔fasting blood glucose(FBG),Cys - C,triacylglycerol (TG), total cholesterol ( TC ), high density lipoprotein cholesterol ( HDL - C ), low density lipoprotein cholesterol (LDL - C)〕 were examined and compared,carotid IMT and ambulatory blood pressure 〔 24 h average systolic pressure (24 hSBP)and 24 h average diastolic pressure(24 hDBP)〕. Results There were significant differences in age,Cys - C and 24 hSBP between the two groups of Uygur patients( P < 0. 05),and there were significant differences in age and Cys - C between the two groups of Han patients(P < 0. 05). Among Uygur patients,carotid IMT was positively related with age,FBG, Cys - C and 24 hSBP(P < 0. 05);after further adjustment of age,FBG and 24 hSBP,Cys - C was still positively associated with carotid IMT( r = 0. 217,P = 0. 010) . Among Han patients,carotid IMT was positively related with age,BMI and 24 hSBP and was negatively related with Cys - C(P < 0. 05);after further adjustment of age,BMI and 24 hSBP,Cys - C was still negatively associated with Cys - C(r = - 0. 163,P = 0. 038). Multivariate Logistic regression analysis showed that age and Cys - C were influencing factors for carotid IMT in Uygur patients,and age was an influencing factor for carotid IMT in Han patients(P < 0. 05). Conclusion Cys - C level is a risk factor for carotid IMT in Uygur patients with essential hypertension, and it probably has no correlation with carotid IMT in Han patients with essential hypertension.