节点文献
高血压患者血清脂联素水平与血管重构的相关性研究
Research on the Relationship between Serum Adiponectin and Vascular Remodeling in Essential Hypertension Patients
【作者】 杨婷；
【导师】 王瑞英；
【作者基本信息】 山西医科大学 ， 心血管内科， 2010， 硕士
【摘要】 目的：研究高血压患者血清脂联素水平与颈动脉内膜中层厚度、踝臂指数的相关性。方法：依照中国高血压防治指南(2005年修订版)制定的诊断标准,将入选者分为正常对照组(40例)和高血压组(120例)。高血压组按不同血压水平分为3个亚组：1级高血压组、2级高血压组、3级高血压组。所有入选者均检测血压、身高、体重、腰围、臀围等指标,计算体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)等。采用酶联免疫吸附法测定血清脂联素浓度。应用美国ATL彩色多普勒超声仪检测颈动脉内膜中层厚度。应用日本ES—100V3超声仪测量并计算受试者踝臂指数。结果：(1)与正常对照组比较,高血压组血清脂联素浓度、踝臂指数明显降低,颈动脉内膜中层厚度增加,差异具有统计学意义(P＜0.05)。且高血压各亚组间两两比较也具有统计学差异,说明脂联素浓度随着血压升高逐渐降低,而颈动脉内膜中层厚度呈逐渐增高趋势。2级、3级高血压组与正常组比较,踝臂指数差异具有统计学意义(P＜0.05)。高血压各亚组间两两比较踝臂指数差异无统计学意义(P＞0.05)。(2)Pearson相关分析显示,高血压组脂联素浓度与收缩压、舒张压、BMI、TG、HO MA-IR.颈动脉内膜中层厚度呈负相关(P＜0.05,P＜0.01),与踝臂指数呈正相关(P＜0.05),而与PP、TC、HDL-C、LDL-C相关性不显著。(3)多元线性回归分析显示,高血压组年龄、收缩压、BMI、TG是影响血清脂联素的独立因素(R2=0.580,P＜0.05)。结论：血清脂联素浓度与颈动脉内膜中层厚度、踝臂指数密切相关。脂联素可能是高血压患者发生早期血管病变的中介环节,可作为预测血管病变程度的指标,并有可能成为今后高血压患者治疗的靶点之一。
【Abstract】 Obesity:To evaluate the relationship between the adiponectin (APN) levels and intima-media thickness (IMT)、ankle brachia index (ABI) in patients with essential hypertension(EP).Methods:120 patients with essential hypertension and 40 healthy subjects were studied.Then we divided the EP group to 3 subgroups according to the blood pressure levels.Serum adiponectin was assayed by radio-immunoassay (RIA), and related parameters such as blood pressure、height、weight、waist circumference (WC) and so on were measured. According to the typical HOMA model, insulin resistance index (HOMA-IR) were calculated.Intima-media thickness and ankle brachia index were both determined.Results:(1)Compared with the healthy group, the serum APN、ABIof the EP group was lower and the IMT was higher (P<0.05). The differences of serum APN、IMT between healthy group、1、2、3 subgroups were both significant. (2) Pearson-correlation analysis revealed APN of EP group was negatively correlated with SBP、DBP、BMI、TG、HOMA-IR、IMT(P<0.05, P (0.01). APN was positive correlation with ABI(P <0.05). (3) Multiple regression analysis showed that age、SBP、BMI、TG were independent factor to logAPN in EP group (R2=0.580, P<0.05).Conclusion:The serum adiponectin has a closed relationship with intima-media thickness and ankle brachia index. Adiponectin maybe joined in the process of hypertension. It suggests that APN could be the index to vascular remodeling of hypertension. And APN could be used in the therapy of the hypertension.