血清Cys-C、hs-CRP与原发性高血压患者左室重构的相关性研究

发布时间：2018-06-26 17:34

本文选题：胱抑素C + 高敏C反应蛋白　；参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨Cys-C、hs-CRP与EH患者左室重构的相关性,给临床判断心室重构的严重程度及早期监测心室重构的发生、发展提供理论根据。方法:选取2015年11月至2016年11月在青海大学附属医院老年科住院的EH患者120例。归纳一般资料:年龄、性别、体重、身高等。计算BSA、BMI。空腹8h,次日凌晨抽外周静脉血送本院检验科检测Cys-C、hs-CRP,血尿酸、血糖等指标。完善心脏彩超检查:记录舒张末期室间隔厚度、舒张末期左室内径、舒张末期左室后壁厚度等,算出:左室质量指数(LVMI)、相对室壁厚度(RWT)。参照左室构型分型标准分组:左室正常构型(NG)组40例和左室重构组80例。左室重构组:向心性重构(CCR)组32例、向心性肥厚(CCH)组17例、离心性肥厚(ECH)组31例。NG组设为对照组。应用spss19.0分析数据。结果:1、四组间:性别、年龄、BMI、BSA、BUN、Scr、Ccr、Ua、Glu、TCH、TG、HDL、LDL、WBC、SBP、DBP比较,差异无统计学意义(P0.05);高血压病程比较,CCR组、CCH组、ECH组高于NG组,差异有统计学意义(P0.05),CCR组、CCH组、ECH组三组间,差异无统计学意义(P0.05)。2、四组间:Cys-C、hs-CRP比较,ECH组、CCH组、CCR组高于NG组,ECH组、CCH组高于CCR组,ECH组高于CCH组,差异有统计学意义(P0.05);LVMI比较,ECH组、CCH组、CCR组高于NG组,ECH组、CCH组高于CCR组,差异有统计学意义(P0.05),ECH组与CCH组间,差异无统计学意义(P0.05);RWT比较,CCH组、CCR组高于NG组,ECH组低于CCR组,ECH组低于CCH组,差异有统计学意义(P0.05);ECH组与NG组间、CCH组与CCR组间,差异无统计学意义(P0.05)。3、Cys-C、hs-CRP、高血压病程分别与LVMI呈正相关,相关系数分别为(r=0.390,0.404,0.202,均P0.05);Cys-C、hs-CRP、高血压病程分别与RWT无相关。4、Cys-C与hs-CRP呈正相关,r=0.399、P0.001;Cys-C、hs-CRP分别与高血压病程无相关。5、二元logistic回归分析提示:Cys-C(OR=14.982,P0.05)、hs-CRP(OR=3.633,P0.05)是EH患者发生左室重构的危险因素,Cys-C比hs-CRP的危险度高。结论:1、EH患者左室重构程度随血清Cys-C、hs-CRP水平升高而加重,Cys-C、hs-CRP与左室重构相关,Cys-C、hs-CRP是左室重构的危险因素,Cys-C比hs-CRP的危险度高。2、Cys-C与hs-CRP相关,二者协同参与左室重构的演变过程。3、通过检测EH患者血清Cys-C、hs-CRP水平有利于早期监测心室重构,可协助判断心室重构的严重程度。
[Abstract]:Objective: to investigate the correlation between Cys-Cnhs-CRP and left ventricular remodeling in EH patients, and to provide a theoretical basis for clinical evaluation of the severity of ventricular remodeling, early monitoring of ventricular remodeling and its development. Methods: 120 EH patients hospitalized in geriatrics department of Qinghai University affiliated Hospital from November 2015 to November 2016 were selected. Summary of general data: age, sex, weight, height, etc. The BSA-BMIs were calculated. After 8 hours of fasting, peripheral venous blood was collected in the early morning of the next day to be sent to our hospital for examination of Cys-Cn hs-CRP, uric acid, blood glucose and so on. The left ventricular septal thickness, left ventricular diameter and left ventricular posterior wall thickness were recorded. The left ventricular mass index (LVMI) and the relative wall thickness (RWT) were calculated. According to the criteria of left ventricular conformation classification, 40 cases of normal left ventricular configuration (NG) group and 80 cases of left ventricular remodeling group were divided into two groups. Left ventricular remodeling group consisted of 32 patients with concentric remodeling (CCR), 17 patients with concentric hypertrophy (CCH) and 31 patients with eccentric hypertrophy (ECH). Spss19.0 was used to analyze the data. Results there was no significant difference in sex, age, sex and age between CCH group and CCH group (P 0.05). There was no significant difference in DBP between CCH group and CCH group (P 0.05), and there was no significant difference between CCH group and CCH group in ECH group compared with that in NG group (P0.05), and there was no significant difference (P0.05) between CCH group and CCH group in CCH group (P > 0.05), but there was no significant difference between two groups (P0.05), and there was no significant difference in DBP between CCH group and CCH group in CCH group (P 0.05), and there was no significant difference in the duration of hypertension between CCH group and NG group (P0.05). There was no significant difference among the four groups (P0.05). There was no significant difference among the four groups (P0.05). There was no significant difference among the four groups (P0.05). The differences among the four groups were statistically significant (P0.05). The differences between CCH group and CCH group in ECH group were higher than those in CCH group and CCH group in NG group. The difference was statistically significant (P0.05). The difference between CCH group and CCH group in ECH group was higher than that in CCH group in NG group (P0.05), and the difference was significant (P0.05) between CCH group and CCH group in ECH group, and was higher in CCH group than in CCH group in NG group. There was no significant difference between ECH group and CCH group (P0.05). There was no significant difference in RWT between CCH group and CCH group (P0.05). There was no significant difference (P0.05) .3Cys-Cnhs-CRP.The course of hypertension was positively correlated with LVMI. The correlation coefficients were (r = 0.390) 0.404 卤0.202, respectively (P0.05). The course of hypertension was not correlated with RWT. 4) Cys-C was positively correlated with hs-CRP. There was no correlation between Cys-Cnhs-CRP and the course of hypertension. The binary logistic regression analysis showed that the risk factor of left ventricular remodeling in EH patients was Cys-C (OR 14.982U), hs-CRP (OR3.633P 0.05), and the risk of left ventricular remodeling was higher than that of hs-CRP. Conclusion the degree of left ventricular remodeling increases with the increase of serum Cys-Cn hs-CRP level in EH patients. The correlation between Cys-Cn hs-CRP and left ventricular remodeling is that the risk factor of left ventricular remodeling is Cys-C higher than hs-CRP. 2Cys-C is associated with hs-CRP. The level of Cys-Cnhs-CRP in serum of EH patients is helpful for early monitoring of ventricular remodeling and can help to judge the severity of ventricular remodeling.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.11

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