胱抑素C、血浆致动脉硬化指数与高血压的相关性研究
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摘要
目的了解胱抑素C(Cys C)、血浆致动脉硬化指数(AIP)与高血压的相关性及临床意义。方法纳入2014—2015年在衢州市中心医院诊断为原发性高血压的526例患者为高血压组,同期在该院健康体检的血压正常者546人为血压正常组,进行体格检查、血生化指标和Cys C检测,分析Cys C、AIP与各项体检及生化指标的相关性。结果高血压组和血压正常组的血清Cys C水平分别为(1.12±0.44)和(0.81±0.22)mg/L,AIP水平分别为0.68±0.03和-0.22±0.02,两组Cys C、AIP水平差异均有统计学意义(P<0.01)。血清Cys C升高,患高血压的风险随之升高(OR=20.06,95%CI:12.67~31.76)。高血压组的AIP分别与收缩压、体质指数、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、尿酸水平均存在相关性;Cys C除上述指标外,还与肌酐水平存在相关性(均P<0.05)。结论高血压患者的Cys C、AIP水平均高于血压正常者,且这两项指标与收缩压及多项血脂指标存在相关性,可用于临床监测高血压患者的动脉硬化和靶器官损害程度。
Objective To understand the correlation and clinical significance between cystatin C and atherogenic index of plasma change in hypertensive patients. Methods At the Quzhou City central hospital between 2014 and 2015, 526 cases of hypertensive patients as hypertensive group and 546 cases of people with normal blood pressure in the healthy check-up as normal blood pressure group were investigated with physical examination, blood biochemical index detection and the serum cystatin C level detection. The analysis of the relationship between the serum cystatin C level and atherogenic index of plasma among two groups was done. Results The evidence that the serum cystatin C level between hypertensive group and normal blood pressure group shows respectively as:1.12±0.44(mg/L) and 0.81±0.22(mg/L),atherogenic index of plasma shows respectively as:0.68±0.03 and-0.22±0.02,both differences were statistically significant(P<0.01). As the serum cystatin C level increased,the risk of hypertension increased(OR=20.06,95%CI:12.67-31.76). Plasma arteriosclerosis index in hypertensive group was correlated with systolic blood pressure, body mass index, total cholesterol, triglyceride, high-density lipoprotein, LDL cholesterol,and uric acid level respectively,all differences were statistically significant. In addition to the above indicators,the serum cystatin C level in hypertensive group was correlated with serum creatinine level(all P<0.05). Conclusion The serum cystatin C level and plasma arteriosclerosis index in patients with hypertension both were higher than those with normal blood pressure. These two indicators were correlated with systolic blood pressure and multiple blood lipid indicators. They could be used to monitor arteriosclerosis and target organ damage in patients with hypertension.
Objective To understand the correlation and clinical significance between cystatin C and atherogenic index of plasma change in hypertensive patients. Methods At the Quzhou City central hospital between 2014 and 2015, 526 cases of hypertensive patients as hypertensive group and 546 cases of people with normal blood pressure in the healthy check-up as normal blood pressure group were investigated with physical examination, blood biochemical index detection and the serum cystatin C level detection. The analysis of the relationship between the serum cystatin C level and atherogenic index of plasma among two groups was done. Results The evidence that the serum cystatin C level between hypertensive group and normal blood pressure group shows respectively as:1.12±0.44(mg/L) and 0.81±0.22(mg/L),atherogenic index of plasma shows respectively as:0.68±0.03 and-0.22±0.02,both differences were statistically significant(P<0.01). As the serum cystatin C level increased,the risk of hypertension increased(OR=20.06,95%CI:12.67-31.76). Plasma arteriosclerosis index in hypertensive group was correlated with systolic blood pressure, body mass index, total cholesterol, triglyceride, high-density lipoprotein, LDL cholesterol,and uric acid level respectively,all differences were statistically significant. In addition to the above indicators,the serum cystatin C level in hypertensive group was correlated with serum creatinine level(all P<0.05). Conclusion The serum cystatin C level and plasma arteriosclerosis index in patients with hypertension both were higher than those with normal blood pressure. These two indicators were correlated with systolic blood pressure and multiple blood lipid indicators. They could be used to monitor arteriosclerosis and target organ damage in patients with hypertension.
引文
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[12]刘群威,韩丽敏,杜秋帆,等.动态动脉硬化指数、高同型半胱氨酸血症与高血压患者早期肾功能损害的关系[J].中国循证心血管医学杂志,2016,8(8):968-970.
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[14]陈敏,齐国先.胱抑素C在动脉粥样硬化发生发展中的研究新进展[J].心血管病学进展,2015,36(4):391-394.
[15]刘琰凤,吐尔逊·沙比尔,努尔比亚·吾买尔.缺血性脑卒中患者血清胱抑素C与颈动脉粥样硬化间关系的研究进展[J].中国动脉硬化杂志,2016,24(9):969-972.
[16]KOBAYASHI T,YOKOKAWA H,FUJIBAYASHI K,et al.Association between high cystatin C levels and carotid atherosclerosis[J].World J Cardiol,2017,9(2):147-181.
[2]WANG X C,LIU C H,CHEN Y J,et al.Clinical and pathological analysis of the kidney in patients with hypertensive nephropathy[J].Exp Ther Med,2013,6(5):1243-1246.
[3]ZHANG Q,DAVIS K J,HOFFMANN D,et al.Urinary biomarkers track the progression of nephropathy in hypertensive and obese rats[J].Biomark Med,2014,8(1):85-94.
[4]OTSUKA T,KATO K,KACHI Y,et al.Serum cystatin C,creatinine-based estimated glomerular filtration rate,and the risk of incident hypertension in middle-aged men[J].Am J Hypertens,2014,27(4):596-602.
[5]OZKOK A,AKPINAR T S,TUFAN F,et al.Cystatin C is better than albuminuria as a predictor of pulse wave velocity in hypertensive patients[J].Clin Exp Hypertens,2014,36(4):222-226.
[6]寇惠娟,马瑞,高登峰,等.高血压患者高尿酸血症与肾损害及血浆致动脉硬化指数的关系[J].岭南心血管病杂志,2016,22(4):442-445.
[7]KASAHARA M,NAKAGAWA T,YOKOI H,et al.Do statins play a role in renoprotection[J].Clin Exp Nephrol,2014,18(2):282-285.
[8]杨彤,李亚刚.血浆致动脉硬化指数与老年高血压患者下肢动脉硬化风险的相关性[J].中国老年学杂志,2015,35(7):1777-1778.
[9]《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版)[J].中华健康管理学杂志.2015,9(1):10-30.
[10]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[11]EDWARDS M K,LOPRINZI P D.The association between muscle strengthening activities and atherogenic index of plasma[J].Prev Med,2016,91(9):318-321.
[12]刘群威,韩丽敏,杜秋帆,等.动态动脉硬化指数、高同型半胱氨酸血症与高血压患者早期肾功能损害的关系[J].中国循证心血管医学杂志,2016,8(8):968-970.
[13]ONAT A,CAN G,KAYA H,et al.“Atherogenic index of plasma”(log10 triglyceride/high-density lipoprotein-cholesterol)predicts high blood pressure,diabetes,and vascular events[J].J Clin Lipidol,2010,4(2):89-98.
[14]陈敏,齐国先.胱抑素C在动脉粥样硬化发生发展中的研究新进展[J].心血管病学进展,2015,36(4):391-394.
[15]刘琰凤,吐尔逊·沙比尔,努尔比亚·吾买尔.缺血性脑卒中患者血清胱抑素C与颈动脉粥样硬化间关系的研究进展[J].中国动脉硬化杂志,2016,24(9):969-972.
[16]KOBAYASHI T,YOKOKAWA H,FUJIBAYASHI K,et al.Association between high cystatin C levels and carotid atherosclerosis[J].World J Cardiol,2017,9(2):147-181.