血压晨峰对老年高血压并冠心病患者血清细胞间黏附分子1、血管细胞黏附分子1水平及外周血单个核细胞核因子κ B p65的影响研究
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摘要
目的探讨血压晨峰对老年高血压并冠心病患者血清细胞间黏附分子1(ICAM-1)、血管细胞黏附分子1(VCAM-1)、外周血单个核细胞核因子κB(NF-κB)p65的影响。方法选取2015年7月—2016年7月绵阳市中心医院心内科收治的老年高血压并冠心病患者94例,根据有无血压晨峰分为对照组(无血压晨峰,n=43)和观察组(有血压晨峰,n=51)。比较两组患者血压、实验室检查指标、外周血单个核细胞NF-κB p65阳性率、冠状动脉病变支数及Gensini积分。结果观察组患者24 h、白天、夜间及晨峰收缩压高于对照组(P<0.05);两组患者24 h、白天、夜间及晨峰舒张压比较,差异无统计学意义(P>0.05)。两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及空腹血糖(FBG)比较,差异无统计学意义(P>0.05);观察组患者血清ICAM-1、VCAM-1水平及外周血单个核细胞NF-κB p65阳性率高于对照组(P<0.05)。观察组患者冠状动脉病变支数多于对照组,Gensini积分高于对照组(P<0.05)。结论老年高血压并冠心病患者血压晨峰主要表现为收缩压晨峰,而血压晨峰可导致血清ICAM-1、VCAM-1水平及外周血单个核细胞NF-κB p65表达升高,加重冠状动脉病变严重程度。
Objective To investigate the impact of blood pressure morning surge on serum levels of ICAM-1 and VCAM-1,and peripheral blood mononuclear cell(PBMC)NF-κB p65 in elderly hypertension patients merged with coronary heart disease. Methods From July 2015 to July 2016,a total of 94 elderly hypertension patients merged with coronary heart disease were selected in the Department of Cardiology,the Central Hospital of Mianyang,and they were divided into control group(without blood pressure morning surge,n=43)and observation group(with blood pressure morning surge,n=51)according to the incidence of blood pressure morning surge. Blood pressure,laboratory examination results,positive rate of PBMC NF-κB p65,number of stenosed coronary arteries and Gensini score were compared between the two groups. Results Compared with control group,24-hour SBP,daytime SBP,nighttime SBP and morning peak SBP in observation group were statistically significantly higher than those in control group(P<0.05),while no statistically significant differences of 24-hour DBP,daytime DBP,nighttime DBP or morning peak DBP was found between the two groups(P>0.05). No statistically significant differences of TC,TG,LDL-C or FBG was found between the two groups(P>0.05),while serum levels of ICAM-1 and VCAM-1,and positive rate of PBMC NF-κB p65 in observation group were statistically significantly higher than those in control group(P<0.05).The number of stenosed coronary arteries and Gensini score in observation group was statistically significantly more than that in control group,and Gensini score in observation group was statistically significantly higher than that in control group(P<0.05). Conclusion Blood pressure morning surge mainly performed as SBP morning surge in elderly hypertension patients merged with coronary heart disease,it may results in increase of serum levels of ICAM-1 and VCAM-1,and PBMC NF-κB p65 expression,aggravate the severity of coronary artery lesions.
Objective To investigate the impact of blood pressure morning surge on serum levels of ICAM-1 and VCAM-1,and peripheral blood mononuclear cell(PBMC)NF-κB p65 in elderly hypertension patients merged with coronary heart disease. Methods From July 2015 to July 2016,a total of 94 elderly hypertension patients merged with coronary heart disease were selected in the Department of Cardiology,the Central Hospital of Mianyang,and they were divided into control group(without blood pressure morning surge,n=43)and observation group(with blood pressure morning surge,n=51)according to the incidence of blood pressure morning surge. Blood pressure,laboratory examination results,positive rate of PBMC NF-κB p65,number of stenosed coronary arteries and Gensini score were compared between the two groups. Results Compared with control group,24-hour SBP,daytime SBP,nighttime SBP and morning peak SBP in observation group were statistically significantly higher than those in control group(P<0.05),while no statistically significant differences of 24-hour DBP,daytime DBP,nighttime DBP or morning peak DBP was found between the two groups(P>0.05). No statistically significant differences of TC,TG,LDL-C or FBG was found between the two groups(P>0.05),while serum levels of ICAM-1 and VCAM-1,and positive rate of PBMC NF-κB p65 in observation group were statistically significantly higher than those in control group(P<0.05).The number of stenosed coronary arteries and Gensini score in observation group was statistically significantly more than that in control group,and Gensini score in observation group was statistically significantly higher than that in control group(P<0.05). Conclusion Blood pressure morning surge mainly performed as SBP morning surge in elderly hypertension patients merged with coronary heart disease,it may results in increase of serum levels of ICAM-1 and VCAM-1,and PBMC NF-κB p65 expression,aggravate the severity of coronary artery lesions.
引文
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[12]CERAVOLO R,MAIO R,PUJIA A,et a1.Pulse pressure and endothelial dysfunction in never-treated hypertensive patients[J].J Am Coll Cardiol,2003,41(10):1753-1758.
[13]CALISKAN M,CALISKAN Z,GULLU H,et al.Increased morning blood pressure surge and coronary microvascular dysfunction in patient with early stage hypertension[J].J Am Soc Hypertens,2014,8(9):652-659.DOI:10.1016/j.jash.2014.05.010.
[14]FOTIS L,AGROGIANNIS G,VLACHOS I S,et al.Intercellular adhesion molecule(icam)-1 and vascular cell adhesion molecule(vcam)-1 at the early stages of atherosclerosis in a rat model[J].In Vivo,2012,26(2):243-250.
[15]BLANKENBERG S,BARBAUX S,TIRET L.Adhesion molecules and atherosclerosis[J].Atherosclerosis,2003,170(2):191-203.
[16]LEE F Y,LU H I,CHAI H T,et al.Circulating microparticles enhanced rat vascular wall remodeling following endothelial denudation[J].Am J Transl Res,2016,8(11):4511-4522.
[17]WANG X,CHEN Q,PU H,et al.Adiponectin improves NF-κB-mediated inflammation and abates atherosclerosis progression in apolipoprotein E-deficient mice[J].Lipids Health Dis,2016,18(15):33.DOI:10.1186/s12944-016-0202-y.
[18]YANG J X,PAN Y Y,GE J H,et al.Tanshinone II A Attenuates TNF-α-Induced Expression of VCAM-1 and ICAM-1 in Endothelial Progenitor Cells by Blocking Activation of NF-κB[J].Cell Physiol Biochem,2016,40(1/2):195-206.DOI:10.1159/000452537.
[19]GAO J J,HU Y W,WANG Y C,et al.Apo M Suppresses TNF-α-Induced Expression of ICAM-1 and VCAM-1 Through Inhibiting the Activity of NF-κB[J].DNA Cell Biol,2015,34(8):550-556.DOI:10.1089/dna.2015.2892.
[20]LIBBY P.Inflammation in atherosclerosis[J].Arterioscler Thromb Vasc Biol,2012,32(9):2045-2051.DOI:10.1161/ATVBAHA.108.179705.
[21]PUCCI G,BATTISTA F,ANASTASIO F,et al.Morning pressor surge,blood pressure variability,and arterial stiffness in essential hypertension[J].J Hypertens,2017,35(2):272-278.DOI:10.1097/HJH.0000000000001153.
[22]NUTHALAPATI R K,INDUKURI B R.Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients[J].Indian J Endocrinol Metab,2016,20(2):182-188.DOI:10.4103/2230-8210.176349.
[2]AMODEO C,GUIMARAES G G,PICOTTI J C,et al.Morning blood pressure surge is associated with death in hypertensive patients[J].Blood Press Monit,2014,19(4):199-202.DOI:10.1097/MBP.0000000000000051.
[3]AGITA A,ALSAGAFF M T.Inflammation,Immunity,and Hypertension[J].Acta Med Indones,2017,49(2):158-165.
[4]ALPAYDIN S,TURAN Y,CALISKAN M,et al.Morning blood pressure surge is associated with carotid intima-media thickness in prehypertensive patients[J].Blood Press Monit,2017,22(3):131-136.DOI:10.1097/MBP.0000000000000252.
[5]BASZCZUK A,KOPCZYNSKI Z,KOPCZYNSKI J,et al.Impact of administration of folic acid on selected indicators of inflammation in patients with primary arterial hypertension[J].Postepy Hig Med Dosw(Online),2015,69:429-435.
[6]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-708.
[7]GENSINI G G.A more meaningful scoring system for determining the severity of coronary heart disease[J].Am J Cardiol,1983,51(3):606.
[8]WHITE W B.Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate[J].Blood Press Monit,2001,6(2):63-72.
[9]HOSHIDE S,KARIO K.Early morning hypertension/morning blood pressure surge[J].Nihon Rinsho,2014,72(8):1395-1399.
[10]SUN N,XI Y,JING S,et al.Morning blood pressure surge varies with age and gender in hypertensive individuals[J].Int J Cardiol,2009,135(2):272-273.DOI:10.1016/j.ijcard.2008.03.061.
[11]PIERDOMENICO S D,PIERDOMENICO A M,DI TOMMASO R.Morning Blood Pressure Surge,Dipping,and Risk of Coronary Events in Elderly Treated Hypertensive Patients[J].Am J Hypertens,2016,29(1):39-45.DOI:10.1093/ajh/hpv074.
[12]CERAVOLO R,MAIO R,PUJIA A,et a1.Pulse pressure and endothelial dysfunction in never-treated hypertensive patients[J].J Am Coll Cardiol,2003,41(10):1753-1758.
[13]CALISKAN M,CALISKAN Z,GULLU H,et al.Increased morning blood pressure surge and coronary microvascular dysfunction in patient with early stage hypertension[J].J Am Soc Hypertens,2014,8(9):652-659.DOI:10.1016/j.jash.2014.05.010.
[14]FOTIS L,AGROGIANNIS G,VLACHOS I S,et al.Intercellular adhesion molecule(icam)-1 and vascular cell adhesion molecule(vcam)-1 at the early stages of atherosclerosis in a rat model[J].In Vivo,2012,26(2):243-250.
[15]BLANKENBERG S,BARBAUX S,TIRET L.Adhesion molecules and atherosclerosis[J].Atherosclerosis,2003,170(2):191-203.
[16]LEE F Y,LU H I,CHAI H T,et al.Circulating microparticles enhanced rat vascular wall remodeling following endothelial denudation[J].Am J Transl Res,2016,8(11):4511-4522.
[17]WANG X,CHEN Q,PU H,et al.Adiponectin improves NF-κB-mediated inflammation and abates atherosclerosis progression in apolipoprotein E-deficient mice[J].Lipids Health Dis,2016,18(15):33.DOI:10.1186/s12944-016-0202-y.
[18]YANG J X,PAN Y Y,GE J H,et al.Tanshinone II A Attenuates TNF-α-Induced Expression of VCAM-1 and ICAM-1 in Endothelial Progenitor Cells by Blocking Activation of NF-κB[J].Cell Physiol Biochem,2016,40(1/2):195-206.DOI:10.1159/000452537.
[19]GAO J J,HU Y W,WANG Y C,et al.Apo M Suppresses TNF-α-Induced Expression of ICAM-1 and VCAM-1 Through Inhibiting the Activity of NF-κB[J].DNA Cell Biol,2015,34(8):550-556.DOI:10.1089/dna.2015.2892.
[20]LIBBY P.Inflammation in atherosclerosis[J].Arterioscler Thromb Vasc Biol,2012,32(9):2045-2051.DOI:10.1161/ATVBAHA.108.179705.
[21]PUCCI G,BATTISTA F,ANASTASIO F,et al.Morning pressor surge,blood pressure variability,and arterial stiffness in essential hypertension[J].J Hypertens,2017,35(2):272-278.DOI:10.1097/HJH.0000000000001153.
[22]NUTHALAPATI R K,INDUKURI B R.Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients[J].Indian J Endocrinol Metab,2016,20(2):182-188.DOI:10.4103/2230-8210.176349.