原发性高血压患者颈动脉内膜中层厚度与脂蛋白相关磷脂酶A2水平相关性研究  

Correlation between carotid artery intima-media thickness（IMT） and lipoprotein-associated phospholipase A2 level in patients with essential hypertension

作　　者：郑冠群[1] 盛晓东[1] 周建龙[1] 范韬[1] 金骁琦[1] 

机构地区：[1]扬州大学医学院附属常熟医院心血管内科,江苏省常熟市215500

出　　处：《中国心血管病研究》2015年第10期909-912,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨原发性高血压（EH）患者血浆脂蛋白相关磷脂酶A2（Lp-PLA2）水平与原发性高血压患者颈动脉内膜中层厚度（IMT）的相关性.方法 选择90例EH患者,其中单纯EH患者46例（单纯EH组）、EH合并颈动脉硬化（CAS）患者44例（EH伴发CAS组）;另选取同期在我院体检的40名健康者作为正常对照组.应用颈动脉彩色多普勒超声检查IMT,检测三组血浆Lp-PLA2水平及其他生化指标并进行比较.结果 单纯EH组和EH伴发AS组与正常对照组相比,其收缩压（SBP）[（150.87±10.62）mm Hg比（162.38±16.13）mm Hg比（123.31 ±9.23）mm Hg]、舒张压（DBP）[（89.44±9.71）mm Hg比（94.32±11.86）mm Hg比（76.31±7.48）mmHg]、同型半胱氨酸（Hcy）[（9.25±4.13） μmol/L比（13.64±5.48）μmol/L比（6.03±3.01）μmol/L]、白介素（IL）-2[（145.12±16.14）pg/ml比（168.77±21.24）pg/ml比（124.00±5.25）pg/ml]及Lp-PLA2水平[（113.0±32.73）ng/ml比（292.1 ±69.87）ng/ml比（65.32±20.01）ng/ml]均显著升高,且EH伴发CAS组SBP、Hcy 、IL-2及Lp-PLA2水平又明显高于单纯EH组,颈动脉IMT[（1.10±0.17）mm]、超敏C-反应蛋白（hs-CRP）[（5.72±2.51）mg/L]及载脂蛋白（APO）-B/APO-A1比值（0.79±0.22）明显高于正常对照组及单纯EH组,差异均有统计学意义（均P＜0.05）.EH患者血浆Lp-PLA2水平与IMT、Hcy、hs-CRP以及IL-2呈正相关（r=0.402、0.335、0.226、0.214,P＜0.05）.多元逐步回归分析显示,IMT、Hcy为影响血浆Lp-PLA2水平的相关因素.结论 EH患者血浆Lp-PLA2水平与颈动脉IMT密切相关.Lp-PLA2检测对EH患者伴发CAS有预测意义,为CAS早期诊断和干预治疗提供积极的参考价值.Objective To investigate the correlation between the level of plasma lipoprotein associated phospholipase A2（Lp-PLA2） and carotid artery intima-media thickness （IMT） in patients with essential hypertension（EH）. Methods 90 patients with EH were divided into EH group（46 eases） and EH with carotid atheroscle- rosis （CAS）group （44 cases）. Meanwhile, 40 healthy people who received physical examination were selected as control group. Carotid color Doppler ultrasonography was used to measure IMT of internal carotid artery. The level of plasma Lp-PLA2 and some biochemical in three groups were detected for study. Results Compared with the control group, the level of systolic pressure（SBP）[ （150.87±10.62）mm Hg vs （162.38＋16.13）mm Hg vs （123.31± 9.23 ）mm Hg ], diastolic pressure （ DBP ） [ （89.44±9.71 ）mm Hg vs （94.32± 11.86 ）ram Hg vs （ 76.31 ±7.48 ）ram Hg ], homocysteine （Hey） [ （9.25 ±4.13 ）μmol/L vs （ 13.64＋5.48 ）μmol/L vs （6.03 ±3.01 ）μmol/L ], interleukin （IL） -2 [ （ 145.12±16.14）pg/ml vs （ 168.77±21.24）pg/ml vs （ 124.00±5.25）pg/ml] and Lp-PLA2 [ （ 113.0±32.73）ng/ml vs （292.1±69.87）ng/ml vs （65.32±20.01）ng/mt] in EH group and EH with CAS group were significantly higher, and the level of SBP, Hcy, IL-2 and Lp-PLA2 in EH with CAS group were significantly higher than EH group, IMT [ （ 1.10 ±0.17 ）mm ], hypersensitive C -reactive protein （hs -CRP） [ （5.72 ±2.51 ）mg/L ] and apolipoprotein （APO）-B/APO-A1 （0.79±0.22） were higher than control group and EH group. The level of Lp-PLA2 was positively correlated with IMT, Hcy, hs-CRP and IL-2 in EH patients （r=0.402, 0.335, 0.226, 0.214, P〈0.05）. Multiple stepwise regression analysis showed that IMT and Hcy were the related factors of Lp-PLA2. Conclusion The level of Lp-PLA2 is significantly related to the IMT in EH patients. Lp-PLA2 detection has significance for prediction of CAS in patients with EH, and can provide a positive refer

关 键 词：原发性高血压 颈动脉粥样硬化 脂蛋白相关磷脂酶A2 颈动脉内膜中层厚度 

分 类 号：R544.1[医药卫生—心血管疾病]