摘要
目的探讨原发性高血压(EH)患者胆红素及氧化应激表达,及其与颈动脉粥样硬化的关系。方法连续入选2015年3月~2016年12月于琼海市人民医院心血管内科治疗的EH患者187例,根据彩色多普勒超声检查颈动脉内膜中层厚度(IMT)将患者分为EH患者(对照组,n=97)和EH合并动脉粥样硬化患者(研究组,n=90)。检测患者血清中胆红素水平,包括总胆红素(TBIL)、直接胆红素(DBIL)和间接胆红素(IBIL)水平,另外检测血清中氧化应激水平,包括同型半胱氨酸(HCY)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)及氧化型低密度脂蛋白(OX-LDL)水平。对比分析两组患者胆红素水平及氧化应激因子水平,同时分析不同动脉粥样硬化程度患者的各检测因子水平及相关性,另外分析各检测因素的相关性。结果两组患者年龄、性别构成比、体质指数(BMI)、病程等比较,差异均无统计学意义(P>0.05)。与对照组相比,研究组患者TBIL、DBIL、IBIL、SOD和NO水平均明显下降,而HCY、MDA及OX-LDL水平均显著升高,且差异均具有统计学意义(P均<0.05)。随着动脉粥样硬化程度的升高,各组患者检测因子水平之间的差异均具有统计学意义(P<0.05),与内膜增厚组相比,内膜斑块形成组和内膜狭窄组患者的TBIL、DBIL、IBIL、SOD及NO水平明显下降,而HCY、MDA及OX-LDL水平显著升高;与内膜斑块形成组相比,内膜狭窄组患者的TBIL、DBIL、IBIL、SOD及NO水平明显下降,而HCY、MDA及OX-LDL水平显著升高,且差异均具有统计学意义(P均<0.05)。相关性分析结果显示,IMT值与TBIL、DBIL、IBIL、SOD和NO水平呈负相关,而HCY、MDA及OX-LDL水平呈正相关(P<0.05)。同时,各检测指标存在密切的相关性,TBIL、DBIL、IBIL、SOD和NO水平与HCY、MDA及OX-LDL水平之间呈负相关,TBIL、DBIL、IBIL、SOD和NO水平之间呈正相关,HCY、MDA及OX-LDL水平之间呈正相关(P均<0.05)。结论原发性高血压患者合并动脉粥
Objective To explore the expression of bilirubin and oxidative stress of patients with essential hypertension （EH） and its relationship with carotid atherosclerosis. Method According to the color doppler ultrasound carotid intima-media thickness （IMT）, 187 patients with EH from March 2015 to December 2016 were divided into control group （patients with EH, n=97） and research group （patients with EH merger with atherosclerosis, n=90）. The levels of oxidative stress in serum were measured, including total bilirubin （TBIL）, direct bilirubin （DBIL） and indirect bilirubin （IBIL）. In addition, the levels of homocysteine （HCY）, superoxide dismutase （SOD）, malondialdehyde （MDA）, nitric oxide （NO） and oxidized low density lipoprotein （OX-LDL） in serum were measured. The levels of BIL and oxidative stress factors of two groups of patients were compared, at the same time, the levels and relevance of the degree of atherosclerosis and various detection factors were analyzed. Additionally, the correlation among detection factors were analyzed. Results The levels of TBIL, DBIL, IBIL, SOD and NO of patients in research group were significantly lower than those in control group, while levels of HCY, MDA and OX-LDL were significantly higher than those in control group, and the differences were statistically significant （P〈0.05）. With the increase of the degree of atherosclerosis, the differences of levels of detection factors were statistically significant （P〈0.05）. The levels of TBIL, DBIL, IBIL, SOD and NO in intimal plaque formation group and narrow group were lower than those in intimal thickening group （P〈0.05）. The levels of HCY, MDA and OX-LDL were significantly higher than those in intimal thickening group （P〈0.05）. The levels of TBIL, DBIL, IBIL, SOD and NO in narrow group were significantly higher than those in intimal plaque formation group, while the levels of HCY, MDA and OX-LDL were significantly higher than those in lining plaque formation group,
出处
《中国循证心血管医学杂志》
2017年第9期1040-1044,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
海南省2014年度普通医学科研项目(14A210213)
关键词
原发性高血压
胆红素
氧化应激
颈动脉粥样硬化
Essential hypertension
Bilirubin
Oxidative stress
Carotid artery atherosclerosis
