白大衣高血压患者炎症介质与颈动脉内膜中层厚度的分析  

Study on the serum inflammatory mediators and the carotid intima-media thickness in patients with white coat hypertension

作　　者：王天明[1] 

机构地区：[1]济宁医学院附属金乡医院心内科,山东济宁272200

出　　处：《中国医疗前沿》2009年第3期27-28,30,共3页China Healthcare Innovation

摘　　要：目的观察白大衣高血压(white coat hypertension,WCH)患者血清中肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)水平和颈动脉内膜中层厚度(intima-media thickness,IMT),评价其临床意义。方法研究对象90例,分为白大衣高血压组(A组,n=30),非白大衣高血压组(B组,n=30)及健康对照组(C组,n=30);以多普勒超声测定IMT值,检测、比较各组间TNF-α、IL-6、MDA、SOD、IMT水平。结果三组患者TNF-α、IL-6、MDA、IMT水平B组高于A组(P<0.05或P<0.01),A组高于C组(P<0.01);而SOD水平C组高于A组(P<0.01),A组高于B组(P<0.01)。结论白大衣高血压患者血清细胞因子TNF-α、IL-6、MDA、SOD水平及颈动脉内膜中层厚度及介于EH者与正常血压者之间,反映白大衣高血压时机体已产生免疫调节与自身保护,并且引起靶器官的损害,提示白大衣高血压是介于高血压与正常血压之间的临床状态,应视为原发性高血压(Essential hypertension,EH)早期的表现之一,应受到重视。Objective To observe the level of Tumor necrosis factor-α （TNF-α ）,interleukin-6（IL-6）, malondialdehyde（MDA）, superoxide dismutase（SOD）,in serum, and Carotid intima-media thickness（IMT） in patients with white coat hypertension. Methods the subjects were divided into three groups： white coat hypertension（WCH） group （group A, n=30）, essential hypertension（EH） group （group B, n=30）, and normotensive control （NC）group （group C,n=30）.the Tumor necrosis factor- α （TNF- α ）,interleukin-6 （IL-6）, malondialdehyde （MDA）, superoxide dismutase （SOD） and Carotid intima-media thickness （IMT） were measured and compared to their levels in three groups. Results The levels of TNF -α, IL-6 ,MDA,IMT in patients with EH were higher than those in patients with WCH and NC. The levels of TNF -α ,IL-6 ,MDA ,IMT in patients with WCH were higher than those in patients with NC. But The levels of SOD in patients with NC were higher than those in patients with WCH and EH, The levels of SOD in patients with WCH were higher than those in patients with EH. Conclusion The levels of Inflammatory mediators in serum of white coat hypertension is between hypertension and normal BP controls ,and WCH perhaps plays target organ damage.It means the regulation of immune function and self protection have taken place in white coat hypertension as hypertension patients and white coat hypertension is an early clinic stage of hypertension.

关 键 词：原发性高血压 白大衣高血压 炎症介质 颈动脉中层内膜厚度 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]