原发性高血压患者血压昼夜节律与血浆氧化的低密度脂蛋白/β2-糖蛋白Ⅰ复合物及颈动脉粥样硬化的相关性研究  

Correlation Analysis of the Circadian Rhythmicity of Blood Pressure with Ox-LDL/β2GPI Complex and Carotid Atherosclerosis in Patients with Essential Hypertension

作　　者：吕露露 祝万洁 肖明洋[1] 李祎珂 张娟[1] LYU Lulu;ZHU Wanjie;XIAO Mingyang;LI Yike;ZHANG Juan(Department of Cardiovascular Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院心血管内科,河南省郑州市450000

出　　处：《中国全科医学》2025年第18期2228-2233,共6页Chinese General Practice

基　　金：河南省医学科技攻关项目(LHGJ20220438)。

摘　　要：背景原发性高血压患者的血压水平控制不佳可导致心血管并发症和靶器官损伤,目前我国临床实践中对血压昼夜节律干预较少,且缺乏有效的血清学指标评估高血压患者的心血管疾病风险。目的探讨原发性高血压患者的血压昼夜节律异常与血浆氧化的低密度脂蛋白(ox-LDL)/β2-糖蛋白I(β2GPI)复合物水平、超敏C反应蛋白(hs-CRP)、白介素6(IL-6)及颈动脉粥样硬化的相关性。方法选取2024年1—6月在郑州大学第二附属医院心血管内科和高血压门诊就诊的原发性高血压患者208例为研究对象,行24 h动态血压监测并根据夜间血压下降率把研究对象分为3组:勺型组(83例)、非勺型组(83例)和反勺型组(42例)。收集入组患者的一般资料,进行血糖、肾功能、肝功能、血脂、甲状腺功能、电解质、IL-6、hs-CRP、ox-LDL/β2GPI复合物等指标的检测,进行颈部血管超声检查。最后进行数据收集和统计学处理,分析血压昼夜节律紊乱与血浆ox-LDL/β2GPI复合物水平、hsCRP、IL-6及颈动脉粥样硬化程度之间的相关性,采用多因素Logistic回归分析来探讨原发性高血压患者颈部血管斑块形成的影响因素。结果3组患者性别、年龄、BMI、吸烟、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白比较,差异均无统计学意义(P>0.05)。非勺型组、反勺型组患者hs-CRP、IL-6、oxLDL/β2GPI复合物水平及颈部血管斑块占比均高于勺型组,反勺型组患者hs-CRP水平高于非勺型组(P<0.05)。Pearson相关性分析结果显示,hs-CRP、IL-6、ox-LDL/β2GPI复合物与夜间平均收缩压(nSBP)均呈正相关(r=0.424、0.245、0.480,P<0.05)。多因素Logistic回归分析结果显示,nSBP(OR=1.091,95%CI=1.007~1.182)、hs-CRP(OR=5.141,95%CI=1.700~15.541)、ox-LDL/β2GPI复合物(OR=1.033,95%CI=1.023~1.044)是原发性高血压患者颈部血管斑块形成的独立危险因素(P<0.05)。结论�Background Poor control of blood pressure in patients with essential hypertension can lead to cardiovascular complications and end-organ damage.Nowadays,there are few interventions on the circadian rhythmicity of blood pressure in clinical practice and lack of effective serologic indicators to assess the risk of cardiovascular disease in hypertension patients.Objective To investigate the correlation between circadian rhythmicity of blood pressure and oxidized low-density lipoprotein/β2-glycoprotein I complex(ox-LDL/β2GPI complex),high-sensitivity C reactive protein(hs-CRP),interleukin-6(IL-6)and carotid atherosclerosis(CAS)in patients diagnosed with essential high blood pressure.Methods A total of 208 patients who were diagnosed with essential high blood pressure and treated in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Zhengzhou University from January 2024 to June 2024 were selected to undergo the measure of 24-hour blood pressure and were categorized into three groups according to the reduction of nighttime blood pressure:dipper(83 cases),non-dipper(83 cases)and anti-dipper(42 cases)groups.We collecte the general data of patients in each group and examine levels of lipids,glucose,liver function,kidney function,thyroid function,electrolyte,IL-6,hs-CRP,ox-LDL/β2GPI complex,etc.Then the ultrasound examination was performed to evaluate the carotid plaque.Finally,data collection and statistical processing were performed to analyze the correlation between circadian rhythmicity of blood pressure and levels of ox-LDL/β2GPI complex,hs-CRP,IL-6 and atherosclerotic carotid plaque.Results There was no statistically significant difference in gender,age,BMI,smoking,total cholesterol,triacylglycerol,high-density lipoprotein,low-density lipoprotein and glycated hemoglobin among the 3 groups(P>0.05).Compared with the patients with dipper pattern of hypertension,the non-dipper and anti-dipper pattern of hypertension patients had higher levels of hs-CRP,IL-6,ox-LDL/β2GPI complex,and highe

关 键 词：原发性高血压 昼夜节律 超敏C反应蛋白 氧化的低密度脂蛋白/β2-糖蛋白Ⅰ复合物 颈动脉粥样硬化性疾病 相关性研究 

分 类 号：R544.1[医药卫生—心血管疾病]