高敏C反应蛋白与原发性高血压合并无症状性心肌缺血的关系  

High-Sensitivity C-Reactive Protein and Silent Myocardial Ischemia in Essential Hypertension

作　　者：张莉[1] 刘丰[2] 邹蓉[1] 魏伟民[1] 

机构地区：[1]中山大学附属博济医院心内科,广东省增城市511300 [2]广州市第一人民医院老年科,广东省广州市510180

出　　处：《中国动脉硬化杂志》2010年第8期647-650,共4页Chinese Journal of Arteriosclerosis

基　　金：广州市医药卫生科技项目(2009-YB-198)

摘　　要：目的探讨血清高敏C反应蛋白水平与原发性高血压合并无症状性心肌缺血的关系。方法横断面研究157例轻-中度原发性高血压患者,入选时心电图正常,无已知的冠心病。所有患者行运动试验,异常者行冠状动脉造影,依结果分为无症状性心肌缺血组（n=69）和对照组（n=88）。所有患者记录一般临床指标并免疫比浊法测定血清高敏C反应蛋白水平。结果 69例（43.9%）原发性高血压患者确诊为无症状性心肌缺血;与对照组相比,无症状性心肌缺血组血清高敏C反应蛋白水平升高[（3.13±1.55）mg/L比（1.33±0.91）mg/L,P〈0.001],Logistic回归分析显示性别（OR=9.56,95%CI=2.57-35.60,P=0.001）、高敏C反应蛋白（OR=4.54,95%CI=2.47-8.35,P〈0.001）和冠心病家族史（OR=0.11,95%CI=0.03-0.34,P〈0.001）是发生无症状性心肌缺血的独立危险因素;随血清高敏C反应蛋白水平升高,无症状性心肌缺血患病率增加（P〈0.01）。结论血清高敏C反应蛋白水平与无症状性心肌缺血相关。原发性高血压合并无症状性心肌缺血处于高危状态,需积极治疗,而高敏C反应蛋白可能成为检测原发性高血压合并无症状性心肌缺血的有效手段之一。Aim To assess the relationship between serum high-sensitivity C-reactive protein（hs-CRP） and silent myocardial ischemia（SMI） in essential hypertension. Methods We designed a cross-sectional study with 157 mild or moderate essential hypertension patients having no known coronary heart disease（CHD）.Ischemia was assessed by exercise treadmill testing and coronary arteriography.157 patients were separated into SMI group（n=69） and control group（n=88）.Blood was collected for measurement of hs-CRP concentrations in all enrolled patients. Results A total of 69 patients（43.9%） was found to have SMI.Compared with control group,higher hs-CRP levels were observed in SMI group （3.13± 1.55） mg/L vs（1.33±0.91） mg/L,P〈0.001].Logistic regression analysis revealed gender（OR= 9.56,95% CI=2.57-35.60,P=0.001）,hs-CRP（OR=4.54,95%CI=2.47-8.35,P〈0.001） and family history of CHD（OR=0.11,95% CI=0.03-0.34,P〈0.001） to be associated with greater risk of SMI.A significantly increasing trend of SMI was observed with increasing serum levels of hs-CRP（P〈0.01）. Conclusion Hs-CRP was associated with SMI.Essential hypertension with SMI are at high risk and need aggressive treatment.Hs-CRP might help to detect SMI in patients with essential hypertension.

关 键 词：高敏C反应蛋白 原发性高血压 无症状性心肌缺血 

分 类 号：R5[医药卫生—内科学]