血清胱抑素C与老年高血压患者左室肥厚、慢性心力衰竭的关系
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摘要
目的分析老年高血压患者血清胱抑素C(Cys C)与左室肥厚、慢性心力衰竭的关系。方法纳入老年原发性高血压患者160例,依据超声心动图是否存在左室肥厚以及是否合并慢性心力衰竭,将其分为对照组(单纯原发性高血压组)80例、左室肥厚组48例、左室肥厚伴慢性心衰组32例。测定三组血清Cys C及血浆脑钠肽(BNP)水平,并分析血清Cys C与左室肥厚、心力衰竭指标的相关性。结果对照组、左室肥厚组、左室肥厚伴慢性心衰组患者舒张压比较差异无统计学意义(P> 0. 05),但收缩压依次升高,且血清Cys C、BNP水平依次显著升高,差异有统计学意义(P <0. 05)。同时对照组、左室肥厚组、左室肥厚伴慢性心衰组左室舒张末期内径(LVDD)、室间隔厚度(IVS)、左室后厚度(LVPW)各指标依次显著增加,LVEF依次显著降低,差异有统计学意义(P <0. 05)。相关性分析显示老年高血压患者血清Cys C水平与收缩压、LVDD、IVS、LVPW、BNP呈正相关,与LVEF呈负相关(P <0. 05)。结论老年高血压病患者血清Cys C浓度与左室肥厚、慢性心力衰竭具有显著的相关性。
Objective To analyze the relationship among serum cystatin C( Cys-C),left ventricular hypertrophy( LVH) and chronic heart failure( CHF) in old patients with hypertension.Methods The clinical data of 160 old patients with hypertension treated were retrospectively analyzed. All the patients were detected by echocardiography,including left ventricular end-diastolic diameter( LVDD),left ventricular posterior wall thickness( LVPW),interventricular septal thickness( IVS) and ejection fraction( LVEF).Among the 160 patients,48 patients had LVH.According to the history of chronic heart failure,32 LVH patients were complicated with CHF.Therefore,the included patients were divided into the control group( patients with simple hypertension,n = 80),the LVH group( n = 48) and the LVH with CHF group( n = 32).The levels of serum Cys-C and plasma brain natriuretic peptide( BNP) in each group were determined.The correlation among serum Cys-C,LVH and CHF was analyzed.Results There was no difference in diastolic blood pressure among the three groups( P > 0. 05).However,systolic blood pressure,serum Cys-C,BNP,LVDD,IVS and LVPW were increased significantly in turn,and the increased plasma Cys-C and BNP were obvious( P < 0. 05).Meanwhile,LVDD,IVS and LVPW were increased in turn while LVEF was decreased in turn( P < 0. 05).Correlation analysis showed that serum Cys-C levels were positively correlated with systolic blood pressure,LVDD,IVS,LVPW and BNP,and negatively correlated with LVEF( P < 0. 05).Conclusion There is a significant correlation among serum Cys-C level,LVH and LVH with CHF in old patients with hypertension.
Objective To analyze the relationship among serum cystatin C( Cys-C),left ventricular hypertrophy( LVH) and chronic heart failure( CHF) in old patients with hypertension.Methods The clinical data of 160 old patients with hypertension treated were retrospectively analyzed. All the patients were detected by echocardiography,including left ventricular end-diastolic diameter( LVDD),left ventricular posterior wall thickness( LVPW),interventricular septal thickness( IVS) and ejection fraction( LVEF).Among the 160 patients,48 patients had LVH.According to the history of chronic heart failure,32 LVH patients were complicated with CHF.Therefore,the included patients were divided into the control group( patients with simple hypertension,n = 80),the LVH group( n = 48) and the LVH with CHF group( n = 32).The levels of serum Cys-C and plasma brain natriuretic peptide( BNP) in each group were determined.The correlation among serum Cys-C,LVH and CHF was analyzed.Results There was no difference in diastolic blood pressure among the three groups( P > 0. 05).However,systolic blood pressure,serum Cys-C,BNP,LVDD,IVS and LVPW were increased significantly in turn,and the increased plasma Cys-C and BNP were obvious( P < 0. 05).Meanwhile,LVDD,IVS and LVPW were increased in turn while LVEF was decreased in turn( P < 0. 05).Correlation analysis showed that serum Cys-C levels were positively correlated with systolic blood pressure,LVDD,IVS,LVPW and BNP,and negatively correlated with LVEF( P < 0. 05).Conclusion There is a significant correlation among serum Cys-C level,LVH and LVH with CHF in old patients with hypertension.
引文
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[9]Ryder JR,O'Connell M,Bosch TA,et al.Impaired cardiac autonomic nervous system function is associated with pediatric hypertension independent of adiposity[J].Pediatric Research,2016,79(1):49-54.
[10]Chen X,Sun X,Zhang Q,et al.Uncontrolled blood pressure as an independent risk factor of early impaired left ventricular systolic function in treated hypertension[J]. Echocardiography,2016,33(10):1488-1494.
[11]Nosaka K,Nakamura K,Kusano K,et al.Serum cystatin C as a biomarker of cardiac diastolic dysfunction in patients with cardiac disease and preserved ejection fraction[J]. Congest Heart Fail,2013,19(4):E35-39.
[12]张丽,谢建洪.高龄高血压患者血清胱抑素C与左心室肥厚及心功能的相关性研究[J].心脑血管病防治,2015,15(2):101-103.
[13]闫秋芬.胱抑素C与高血压患者心肌纤维化及左室舒张功能的相关性研究[J].中国医师进修杂志,2012,35(16):61-63.
[14]孙建琦,胡宇宁,汪靖,等.胱抑素C与原发性高血压患者室壁厚度及心功能不全的相关性[J].安徽医学,2013,34(10):1478-1480.
[15]黄蔡华,彭绍蓉.高血压患者血清胱抑素C与心室重构的相关性[J].中华老年心脑血管病杂志,2013,15(9):979-980.
[2]吕国伟,赵玉兰.高血压病患者血清胱抑素C与冠心病的关系[J].中国医药指南,2013,11(16):288-290.
[3]黄茵,黄涌泉,薛金方,等.原发性高血压患者血清胱抑素C与心脏重构的关系[J].中华临床医师杂志:电子版,2013,7(24):35-38.
[4]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[M].北京:民卫生出版社,2011:1-3.
[5]Troosters T,Gosselink R,Decmmer M.Six minute walking distance in healthy elderly subjects.[J].Eur Respir J,1999,14(2):270-274.
[6]刘丽,雷萍.血浆同型半胱氨酸水平检测对原发性高血压患者患冠心病的诊断价值[J].医学临床研究,2014,31(4):690-692.
[7]于静,张莉,冷吉燕,等.血清胱抑素C与原发性高血压患者左心室肥厚的相关性[J].中国老年学杂志,2016,36(10):2363-2365.
[8]李静,徐彤彤,余帆.血清IMD、CysC及FGF23与高血压左心室肥厚的相关性研究[J].安徽医科大学学报,2015,50(2):239-243.
[9]Ryder JR,O'Connell M,Bosch TA,et al.Impaired cardiac autonomic nervous system function is associated with pediatric hypertension independent of adiposity[J].Pediatric Research,2016,79(1):49-54.
[10]Chen X,Sun X,Zhang Q,et al.Uncontrolled blood pressure as an independent risk factor of early impaired left ventricular systolic function in treated hypertension[J]. Echocardiography,2016,33(10):1488-1494.
[11]Nosaka K,Nakamura K,Kusano K,et al.Serum cystatin C as a biomarker of cardiac diastolic dysfunction in patients with cardiac disease and preserved ejection fraction[J]. Congest Heart Fail,2013,19(4):E35-39.
[12]张丽,谢建洪.高龄高血压患者血清胱抑素C与左心室肥厚及心功能的相关性研究[J].心脑血管病防治,2015,15(2):101-103.
[13]闫秋芬.胱抑素C与高血压患者心肌纤维化及左室舒张功能的相关性研究[J].中国医师进修杂志,2012,35(16):61-63.
[14]孙建琦,胡宇宁,汪靖,等.胱抑素C与原发性高血压患者室壁厚度及心功能不全的相关性[J].安徽医学,2013,34(10):1478-1480.
[15]黄蔡华,彭绍蓉.高血压患者血清胱抑素C与心室重构的相关性[J].中华老年心脑血管病杂志,2013,15(9):979-980.