摘要
目的观察降压治疗对原发性高血压患者血压和血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)季节性变异的影响。方法选择2013年夏季就诊于内蒙古医科大学鄂尔多斯临床医学院心内科门诊的原发性高血压患者60例,失访8例,最终研究对象为52例,按照前瞻性随机对照研究方法分为两组,含肾素-血管紧张素-醛固酮系统抑制剂(RASI)组30例,钙通道阻滞剂(CCB)组22例。Epidata 3.1软件建立数据库,两组均在2013年夏季、秋季、冬季及2014年春季来院,采集空腹静脉血,酶联免疫吸附测定法检测血清IL-6、TNF-α浓度,观察两组患者春、夏、秋、冬季血压及血清IL-6、TNF-α浓度的变化。结果两组的收缩压冬季高于夏季[含RASI组:(158±20)mm Hg、(145±12)mm Hg;CCB组:(158±20)mm Hg、(141±9)mm Hg],舒张压冬季高于夏季[含RASI组:(101±13)mm Hg、(93±9)mm Hg;CCB组:(100±4)mm Hg、(90±7)mm Hg],差异均有统计学意义(P均<0.05)。两组血清IL-6浓度冬季明显高于其他季节[含RASI组:春季(44.71±1.93)ng/L,夏季(48.09±7.97)ng/L,秋季(51.62±11.64)ng/L,冬季(60.29±5.64)ng/L;CCB组:春季(52.27±11.38)ng/L,夏季(45.11±8.72)ng/L,秋季(43.86±2.00)ng/L,冬季(71.72±7.79)ng/L],差异均有统计学意义(均P<0.01);两组血清TNF-α浓度冬季明显高于其他季节[含RASI组:春季(208.85±25.21)ng/L,夏季(237.26±33.51)ng/L,秋季(217.93±23.32)ng/L,冬季(304.22±21.01)ng/L;CCB组:春季(225.99±40.92)ng/L,夏季(231.72±49.80)ng/L,秋季(206.82±32.82)ng/L,冬季(352.07±36.50)ng/L],差异均有统计学意义(P均<0.01);春、夏、秋季比较差异无统计学意义(P>0.05);冬季血清IL-6、TNF-α浓度含RASI组低于CCB组(P<0.05)。收缩压和舒张压是秋季及冬季的血清IL-6、TNF-α增高的独立因素(均P<0.05);气温及TNF-α是冬季血清IL-6增高的独立因素(均P<0.05)。结论原发性高血压患者经口服CCB及含有RASI为基础治疗药物的降压治疗,血压及促炎因子的水平仍然存
Objective To observe antihypertensive treatment in patients with essential hypertension, on blood pressure and serum IL-6, TNF-α seasonal variations. Methods Selected the 60 cases of hypertensive patients from hypertension clinic, Erdos Clinical Medical College of Inner Mongolia Medical University, who were admitted in the summer months in 2013. 8 cases were lost, thus the final number of valid cases was 52 for the study. They were divided into two groups according to the prospective randomized study methods, including 30 cases in RASI group and 22 cases in CCB group. With Epidata 3.1 software to establish database, the two groups were all collected in the summer, autumn, winter of 2013 and spring 2014. Collected the fasting morning blood, serum IL-6, TNF-α concentration were observed by ELISA. Results Their SBP, DBP in winter were all higher than in summer [SBP: group RASI:(158±20) mm Hg,(145±12)mm Hg; group CCB:(158±20) mm Hg,(141±9) mm Hg; DBP: group RASI:(101±13) mm Hg,(93±9) mm Hg; group CCB:(100±4) mm Hg,(90±7) mm Hg](P<0.05). Two groups of serum IL-6, TNF alpha concentration were significantly higher in winter than that in spring, summer and autumn [IL-6: group RASI: spring(44.71±1.93) ng/L; summer(48.09±7.97) ng/L, autumn(51.62±11.64) ng/L, winter(60.29±5.64) ng/L; group CCB: spring(52.27±11.38) ng/L, summer(45.11±8.72) ng/L, autumn(43.86±2.00) ng/L, winter(71.72±7.79) ng/L; TNF-α: group RASI: spring(208.85±25.21) ng/L; summer(237.26±33.51) ng/L, autumn(217.93±23.32) ng/L; winter(304.22±21.01) ng/L; group CCB: spring(225.99±40.92) ng/L; summer(231.72±49.80) ng/L, autumn(206.82±32.82) ng/L, winter(352.07±36.50) ng/L](P<0.01); spring, summer and autumn, the difference were not statistically significant(P>0.05); The serum IL-6, TNF-α concentration were significantly lower in group RASI than group CCB in winter, P<0.05. The systolic and diastolic blood pressure are independent factors of the serum IL-6, TNF-α in autumn and winter. The temperature and TNF-α were independent factor
出处
《中华临床医师杂志(电子版)》
CAS
2015年第23期55-59,共5页
Chinese Journal of Clinicians(Electronic Edition)