新疆原发性高血压患者颈动脉粥样硬化与血清Cys-C、PAPP-A及FGF-21水平间的相关性研究
投稿时间:2018-02-27  修订日期:2018-03-21  点此下载全文
引用本文:阿布都扎依尔·买买提,阿不来提·艾则孜,木卡达斯·迪力夏提.新疆原发性高血压患者颈动脉粥样硬化与血清Cys-C、PAPP-A及FGF-21水平间的相关性研究[J].医学研究杂志,2018,47(12):129-134
DOI: 10.11969/j.issn.1673-548X.2018.12.030
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作者单位
阿布都扎依尔·买买提  
阿不来提·艾则孜  
木卡达斯·迪力夏提  
中文摘要:目的 探究新原发性高血压患者颈动脉粥样硬化与胱抑素C(cystatin c,Cys-C)、妊娠相关血浆蛋白A(pregnancy-associated plasma proteins A,PAPP-A)、成纤维细胞生长因子21(fibroblast growth factor 21,FGF-21)水平间的相关性。方法 选取2015年1月~2017年12月于新疆维吾尔自治区人民医院全科医疗科就诊并确定诊断为原发性高血压的患者298例,同时招募健康体检人群95例,根据纳入及排除标准将研究对象根据B型超声测定颈动脉中层厚度及粥样硬化程度分3组,即健康对照组(HC组)、高血压组(HBP组)、高血压合并颈动脉斑块组(HBP+CAS组)。比较3组患者尿素(blood urea nitrogen,BUN)、肌酐(serum creatinine,Scr)、尿酸(uric acid,UA)以及总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(light density lipoprotein,LDL)、载脂蛋白A(apolipoprotein,Apo-A)、载脂蛋白B(apolipoprotein,Apo-B)及Cys-C、PAPP-A和FGF-21水平差异,应用Pearson相关分析和多因素线性回归模型分析颈动脉粥样硬化及内中膜厚度(intimal-medial thickness,IMT)的相关因素。结果 HBP+CAS组的TG(4.48±1.49mmol/L)、TC(2.35±1.12mmol/L)、LDL-C(2.91±0.82mmol/L)、IMT(1.23±0.27mm)、Cys-C(1.06±0.28mg/L)、PAPP-A(7.39±3.36mIU/L)、FGF-21(1.98±0.61ng/ml)水平明显高于HBP组的TG(4.07±1.41mmol/L)、TG(2.02±1.15mmol/L)、LDL-C(2.68±0.83mmol/L)、IMT(0.93±0.12mm)、Cys-C(0.92±0.24mg/L)、PAPP-A(5.66±2.12mIU/L)、FGF-21(1.82±0.53ng/ml)和HC组TG(3.98±1.36mmol/L)、TC(1.94±1.07mmol/L)、LDL-c(2.62±0.78mmol/L)、IMT(0.87±0.13mm)、Cys-C(0.83±0.16mg/L)、PAPP-A(4.88±1.96mIU/L)、FGF-21(1.50±0.45ng/ml),差异有统计学意义(P均<0.05),HBP组和HBP+CAS组间的收缩压分别为144.03±8.58mmHg(1mmHg=0.133kPa)和145.56±8.45mmHg,舒张压分别为93.11±5.85mmHg和94.09±5.76mmHg,差异均无统计学意义(P均>0.05)。多因素线性回归分析,IMT与血清LDL-C、Cys-C、PAPP-A及FGF-21水平有关,并且呈线性回归关系(t=3.140、8.216、3.431、7.654,P=0.002、0.000、0.001、0.000),IMT与收缩压、舒张压、TC、HDL-C无明显相关性(t=1.201、1.258、1.354、-2.008,P=0.231、0.209、0.091、0.059);Pearson相关分析显示,IMT与血清Cys-C、PAPP-A及FGF-21水平的相关性较高(r=0.721、0.680、0.692,P=0.000、0.000、0.000)。多因素Logistic回归分析显示,颈动脉粥样硬化与血清Cys-C、PAPP-A及FGF-21水平有关,并且呈线性回归关系(P=0.000、0.005、0.000)。结论 新疆维、汉族原发性高血压患者的血清Cys-C、PAPP-A和FGF-21水平与CIMT和CAS呈正相关。
中文关键词:原发性高血压  颈动脉粥样硬化  胱抑素C  妊娠相关血浆蛋白A  成纤维细胞生长因子21
 
Correlation between Carotid Atherosclerosis and Serum Cys-C, PAPP-A and FGF-21 levels in Patients with Essential Hypertension in Xinjiang
Abstract:Objective To investigate the relationship between carotid atherosclerosis (CAS)and Cystatin C (Cys-C), pregnancy-associated plasma protein A (PAPP-A) levels in patients with essential hypertension in Xinjiang. Methods From January 2015 to December 2017 in general medical clinic of the Xinjiang Uygur Autonomous Region people's Hospital, 203 Uygur and Han patients with essential hypertension were recruited, and 95 cases of healthy population were recruited. According the determination of the carotid artery intima-media thickness and atherosclerotic degree from B type ultrasound, all patients were divided into the health control group (HC group), hypertension group (HBP group), and hypertension plus CAS group (HBP+CAS group). The Blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA) and total cholesterol (TC), triglyceride (TG), high density lipoprotein High density lipoprotein (HDL), low density lipoprotein (LDL), apolipoprotein (Apo-A), apolipoprotein (Apo-B), Cys-C, PAPP-A and FGF-21 levels in three groups were comparatively analyzed. The Pearson correlation analysis and multivariate linear regression model were used to analyze the related factors of carotid atherosclerosis and intimal-medial thickness (IMT). Results The levels of TG (4.48±1.49mmol/L), TC (2.35±1.12mmol/L), LDL-C (2.91±0.82mmol/L), IMT (1.23±0.27mm), Cys-C PAPP-A (7.39±3.36mIU/L) and FGF-21 (1.98±0.61ng/ml) in the HBP+CAS group were significantly higher than those of HBP group (4.07±1.41mmol/L,2.02±1.15mmol/L,2.68±0.83mmol/L,0.93±0.12mm,0.92±0.24mg/L,5.66±2.12mIU/L,1.82±0.53ng/ml) and HC group (3.98±1.36mmol/L,1.94±1.07mmol/L,2.62±0.78mmol/L,0.87±0.13mm,0.83±0.16mg/L,4.88±1.96mIU/L,1.50±0.45ng/ml), respectively (all P<0.05). The systolic blood pressure of HBP group and HBP+CAS group were 144.03±8.58mmHg and 145.56±8.45mmHg, the diastolic blood pressure was 93.11±5.85mmHg and 94.09±5.76mmHg, respectively (all P>0.05). Multivariate linear regression analysis showed that IMT was related to serum LDL-C, Cys-C, PAPP-A and FGF-21 levels and had a linear regression relationship (t=3.140,8.216,3.431,7.654; P=0.002,0.000,0.001,0.000). There was no significant correlation between IMT and systolic blood pressure, diastolic blood pressure, TC, HDL-C (t=1.201,1.258,1.354,2.008; P=0.231,0.209,0.091,0.059); Pearson correlation analysis showed that IMT Correlation with serum Cys-C, PAPP-A and FGF-21 levels was higher (r=0.721,0.680,0.692; P=0.000,0.000,0.000). Multivariate Logistic regression analysis showed that carotid atherosclerosis was related to serum Cys-c, PAPP-A and FGF-21 levels and had a linear regression relationship (P=0.000,0.005,0.000). Conclusion The levels of serum Cys-C, PAPP-A and FGF-21 in Xinjiang Uygur and Han nationality are positively correlated with carotid IMT and carotid atherosclerosis in patients with essential hypertension.
keywords:Essential hypertension  Carotid atherosclerosis  Cystatin C  Pregnancy-associated plasma protein A  Fibroblast growth factor 21
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