高血压患者肿瘤坏死因子α与动脉顺应性的关系  

TNF-α and Arterial Compliance in Essential Hypertension

作　　者：徐琼[1] 李新立[1] 童敏[1] 卢新政[1] 张海峰[1] 周艳丽[1] 王震震[1] 黄峻[1] 

机构地区：[1]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《中华高血压杂志》2006年第11期915-919,共5页Chinese Journal of Hypertension

摘　　要：目的探讨高血压患者肿瘤坏死因子α(TNF-α)与动脉顺应性的关系。方法按照SBP和(或)DBP≥140/90mmHg诊断为高血压的标准,将366例受试者分为正常对照组和高血压组,用CVProfilorDO-2020动脉脉搏分析仪分别测定各组受试者大动脉弹性指数(C1)、小动脉弹性指数(C2),用放免法分别检测其血清TNF-α和胰岛素浓度,用胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗(IR)。结果(1)高血压组C1(10·55±3·11)mL/mmHg×10,C2(3·62±1·51)mL/mmHg×100均低于正常对照组[(C1=13·24±4·27)mL/mmHg×10,(C2=6·04±2·66)mL/mmHg×100,P均<0·01],而TNF-α(0·31±0·05)ng/mL高于正常对照组(0·24±0·07)ng/mL,P<0·01;(2)偏相关分析显示,在正常对照组中TNF-α与HOMA-IR、体重指数(BMI)正相关(r=0·171,r=0·229,P均<0·05);在高血压组中TNF-α与C1、C2负相关(r=-0·132,r=-0·392,P均<0·05),与BMI、HOMA-IR、舒张压(DBP)、脉压(PP)正相关(BMI:r=0·427,HOMA-IR:r=0·154,DBP:r=0·144,PP:r=0·182,P均<0·05)(3)在高血压组进行多元回归分析显示,影响C1、C2的因素为年龄与SBP。当自变量排除年龄后,TNF-α和HOMA-IR可进入影响C1、C2的回归模型。结论高血压患者TNF-α浓度增高,TNF-α及HOMA-IR与动脉顺应性的相关性依赖于年龄。Objective To investigate the association between tumor necrosis factor＇-α （TNF-α） and arterial compliance in essential hypertension. Methods 211 cases of hypertension were enrolled with 155 healthy subjects as control. Large arterial compliance（C1 ）and small arterial compliance（C2 ）were measured with the CVPro- filor DO-2020 CardioVascular Profiling System. Serum TNF-α and insulin were measured using radioimmunity kits. Insulin resistance was evaluated by insulin resistance index （HOMA-IR）. Results ）1） C1 10.55± 3.11 mL/mm Hg）〈 10, C2 3. 625：1.51 mL/mm Hg× 100 were decreased while TNF-α 0.31±0. 05 ng/mL increased in hypertension group compared with control （ C1 ： = 13.24± 4. 27 mL/mm Hg ×10, C2 = 6.04 ± 2.66 mL/mm Hg× 100, TNF-α：0.24±0. 07 ng/mL, P〈0.01）. （2）TNF-α was positively correlated with HOMA-IR and BMI in control group（r=0. 171, r=0. 229, P〈0. 05 respectively）. In hypertension group TNF-α was positively correlated with HOMA-IR, BMI, DBP, PP but negatively correlated with C1 and C2 ）BMI：r=0. 427, HOMA-IR：r= 0. 154, DBP：r=0. 144, PP：r=0. 182, P〈0.05 respectively）. （3）Multivariate regression analysis in hypertension group showed that SBP and age were determinants of arterial compliance. When age was excluded from in- dependent variables, TNF-α and HOMA-IR were remained as risk factors of arterial compliance. Conclusion TNF-α was increased in hypertension. The association between TNF-α and arterial compliance seems relevant to age.

关 键 词：肿瘤坏死因子Α 胰岛素抵抗 动脉弹性指数 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]