氧化阴离子、脂质过氧化物、血清胱抑素C与原发性高血压的关系
发布时间：2018-11-01 19:38
【摘要】：目的:上世纪中叶开始我国进行了3次大规模成人高血压病普查,普查结果发现我国高血压人群比例呈逐年上升趋势。在上世纪90年代的10年中,我国原发性高血压(Primary Hypertension)的患病率以每年3%的速度逐年增长,其中18.8%的患者是18岁以上的成年人。高血压病是人类历史上严重威胁人类健康的一种疾病,它的危害不仅在因为急性症状的凶险,如高血压危象,更可怕的是长期的高血压会引起心、脑、肾、血管、视网膜等脏器的组织损害,继而引发的严重并发症直接或间接的危害了人类的生活质量。那么早期对高血压的有效控制是必不可少的。多种高血压并发症的病理基础和病生理机制,主要是因为原发性高血压靶器官的内皮细胞结构和功能的改变。氧化阴离子(Oxide anion,O-2)、脂质过氧化物(Lipid peroxide,LPO)和血清胱抑素C(Cystatin C,Cys-C)对血管内皮功能均有一定的影响作用,在心脑血管的疾病和并发症及其预后评估中的意义也已有相关文献报道。但是,有关O-2、LPO、Cys-C水平与各级高血压关系之间的对比研究甚少,本文将高血压与正常人、高血压病人不同等级血压水平间氧化应激状态和临床意义做初步探讨。方法:选择正常人组30例,为体检合格健康人,无心脑血管疾病史,肝肾功能均正常。高血压组则入组2014年至2016年天津医大二院心脏内科住院的原发性高血压病人。根据2010年版中国高血压防治指南中的高血压分级标准,将高血压病人分为三组:(1)1级高血压组(BP:140~159/90~99mmHg)30例;(2)2级高血压组(BP:160~179/100~109mmhg)30例;(3)3级高血压组(BP≥180/110mmhg)45例。原发性高血压组入选人员均排除继发性高血压以及合并慢性肾脏病、恶性肿瘤、Ⅲ级及以上心衰、急性心肌梗塞和急性炎症等。分别对LPO、Cys-C应用ELISA法、对O-2用比色法,对100例高血压患者血清中的O-2、LPO、Cys-C水平的检测,并与30名体检正常人做比较。同时进行正常组与3级高血压组心脏多普勒超声各指标及反应肾功能的血肌酐和血尿酸的数据结果对比。研究数据使用SPSS20.0统计软件进行统计学分析。计量资料数据用((?)±s)表示,多组间比较使用方差分析方法,单样本数据使用Kolmogorov-Smirnov检验,独立样本使用T检验,以p0.05为差异有统计学意义。计数资料采用百分数表示。结果:不同血压水平的高血压患者血清中LPO、Cys-C水平均高于正常健康人组(p0.05);2级和3级高血压病人的LPO和Cys-C水平高于1级高血压病人(p0.05),但2级和3级高血压组之间并无明显差异(p0.05)。3级高血压组的O-2水平明显高于1级高血压组和正常对照组(p0.05)。3级高血压患者血尿酸(Uric Acid,UA)水平、Tei指数和左心室厚度(Left ventricular wall thickness,LVW)明显高于正常对照组(p0.05)。左室射血分数(left ventricular ejection fraction,LVEF)和二尖瓣流速(Mitral flow velocity,VE)与正常组对照,数据呈正态分布(P0.05)。正常对照组与3级高血压组之间的左室射血分数(LVEF)(P0.05)无统计学意义。二尖瓣流速(VE)存在明显差异,(P0.05);左房内径和左室舒张末内径,两组数据呈正态分布(正态性检验P0.05)。左房内径(left atrial diameter,LA)和左室舒张末内径(Left ventricular end-diastolic diameter,LV)存在明显差异(P0.05);室间隔厚度(interventricular septal thickness,IVS)和左室壁厚度,两组数据呈正态分布(正态性检验P0.05),室间隔厚度(IVS)和左室壁厚度(LVW)存在明显差异,(P0.05);3级高血压患者的血肌酐(creatinine,Cr)和血清胱抑素C与正常对照组进行比较,两组数据呈正态分布(正态性检验P0.05),Cr和血清胱抑素C(Cys-c)存在明显差异(P0.05);3级高血压患者的LPO和肌钙蛋白I(cardiac troponin I,cTnI)正常对照组,两组数据呈正态分布(正态性检验P0.05),LPO和cTn I存在明显差异,(P0.05)。结论:1、血清O-2、LPO、Cys-C水平的变化与高血压病的发生发展密切相关。2、氧化应激指标的检测对于早期识别高血压的靶器官损害和预防并发症具有重要意义。
[Abstract]:Objective: In the middle of last century, three large-scale adult hypertension survey was conducted in China. The results showed that the proportion of hypertension population in China was increasing year by year. In the 10 years of the 1990s, the prevalence of primary hypertension increased year by year at 3% a year, of which 18. 8% of patients were adults over 18 years of age. Hypertension is a disease that poses a serious threat to human health in human history. Its harm not only causes damage to tissues of organs such as heart, brain, kidney, blood vessel, retina, etc., because of its dangerous conditions, such as high blood pressure crisis, and more terrible, long-term hypertension. The subsequent serious complications directly or indirectly endanger the quality of life of human beings. The early effective control of hypertension is essential. The pathological basis and function of a variety of hypertension complications are mainly due to the changes of the structure and function of endothelial cells in the target organs of essential hypertension. The effects of oxidation anion (O-2), lipid peroxide (LPO) and cystatin C (OPG-C) on vascular endothelial function were studied. However, the correlation between the levels of O-2, LPO, adiponectin-C and hypertension at all levels was very little, and the status of oxidative stress and its clinical significance in different levels of blood pressure were discussed in this paper. Methods: Thirty patients with normal control group were selected to be eligible for physical examination. There was no history of cardiovascular and cerebrovascular diseases, and the function of liver and kidney was normal. Hypertension group was enrolled in patients with essential hypertension hospitalized in Cardiology Department of Tianjin Medical University from 2014 to 2016. Hypertension patients were divided into three groups: (1) hypertension group (BP: 140 ~ 159/ 90 ~ 99mmHg) in 30 cases; (2) group 2 hypertension group (BP: 160 ~ 179/ 100 ~ 109mmhg) in 30 cases; (3) group 3 hypertension group (BP: 180/ 110mmhg) in 45 cases. All the patients with essential hypertension excluded secondary hypertension and combined with chronic kidney disease, malignant tumor, grade 鈪，
本文编号：2304899
[Abstract]:Objective: In the middle of last century, three large-scale adult hypertension survey was conducted in China. The results showed that the proportion of hypertension population in China was increasing year by year. In the 10 years of the 1990s, the prevalence of primary hypertension increased year by year at 3% a year, of which 18. 8% of patients were adults over 18 years of age. Hypertension is a disease that poses a serious threat to human health in human history. Its harm not only causes damage to tissues of organs such as heart, brain, kidney, blood vessel, retina, etc., because of its dangerous conditions, such as high blood pressure crisis, and more terrible, long-term hypertension. The subsequent serious complications directly or indirectly endanger the quality of life of human beings. The early effective control of hypertension is essential. The pathological basis and function of a variety of hypertension complications are mainly due to the changes of the structure and function of endothelial cells in the target organs of essential hypertension. The effects of oxidation anion (O-2), lipid peroxide (LPO) and cystatin C (OPG-C) on vascular endothelial function were studied. However, the correlation between the levels of O-2, LPO, adiponectin-C and hypertension at all levels was very little, and the status of oxidative stress and its clinical significance in different levels of blood pressure were discussed in this paper. Methods: Thirty patients with normal control group were selected to be eligible for physical examination. There was no history of cardiovascular and cerebrovascular diseases, and the function of liver and kidney was normal. Hypertension group was enrolled in patients with essential hypertension hospitalized in Cardiology Department of Tianjin Medical University from 2014 to 2016. Hypertension patients were divided into three groups: (1) hypertension group (BP: 140 ~ 159/ 90 ~ 99mmHg) in 30 cases; (2) group 2 hypertension group (BP: 160 ~ 179/ 100 ~ 109mmhg) in 30 cases; (3) group 3 hypertension group (BP: 180/ 110mmhg) in 45 cases. All the patients with essential hypertension excluded secondary hypertension and combined with chronic kidney disease, malignant tumor, grade 鈪，
本文编号：2304899
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