摘要
目的探讨不稳定型心绞痛(UA)合并原发性高血压(EH)患者的白细胞介素-18(IL-18)、γ谷氨酰转肽酶/血小板计数(GPR)的水平及意义。方法本研究为横断面研究。收集2017年4月-2019年4月于承德医学院附属医院心脏内科首次以疑似UA收入院并行冠状动脉造影的患者238例,根据是否诊断UA和EH分为UA+EH组(n=95),单纯UA组(n=53),单纯EH组(n=46)、冠状动脉造影未见异常且无高血压者为对照组(n=44)。比较各组患者基础资料、血生化指标、IL-18及GPR差异,并进行Spearman秩相关分析及logistic回归方程按三分位数分层法分析IL-18、GPR水平与UA合并EH的相关性,采用析因设计方差分析比较UA和EH交互作用对血清IL-18水平的影响。结果与对照组相比,UA+EH组、UA组、EH组血清IL-18、GPR水平较高,且UA+EH组IL-18、GPR水平更高。析因设计方差分析结果显示,UA和EH在血清IL-18水平升高方面存在交互作用。相关性分析显示,血清IL-18、GPR与UA+EH患者冠状动脉Gensini评分呈正相关(r=0.628,0.564,均P<0.05)。Logistic回归分析校正混杂变量后显示,中位数水平及高位数水平IL-18、GPR与UA合并EH独立相关(OR=1.430,95%CI 1.158~2.132,P=0.011;OR=1.450,95%CI 1.255~2.882,P<0.001;OR=1.252,95%CI 1.132~2.011,P=0.015;OR=1.376,95%CI 1.210~2.132,P=0.006)。结论IL-18、GPR与冠状动脉狭窄程度有关,UA和EH在IL-18水平升高方面存在交互作用,高水平IL-18、GPR与UA合并EH独立相关。
Objective To investigate the levels of interleukin-18(IL-18),γ-glutamyl transpeptidase to platelet ratio(GPR)in patients with unstable angina pectoris(UA)and essential hypertension(EH).Methods This study was a cross-sectional study.A total of 238 patients suspected UA undergoing coronary angiography at the Department of Cardiology,Affiliated Hospital of Chengde Medical College from April 2017 to April 2019 were recruited and divided into 4 groups[UA+EH group(n=95),UA group(n=53),EH group(n=46),and control group(n=44)],according to their diagnoses.The baseline clinical data,biochemical indexes and levels of IL-18 and GPR were compared among groups,and the association between the levels of serum IL-18 and GPR and UA in EH patients was analysed by Spearman rank correlation analysis and Logistic regression analysis.Factorial analysis of variance was used to analyze the effects of interaction between UA and EH on the level of serum IL-18.Results Compared with control group,the serum IL-18 and GPR levels were higher in three other groups,and were the highest in UA+EH group.Factorial analysis of variance showed that there was interaction between UA and EH on the elevation of serum IL-18.Correlation analysis showed that serum IL-18 and GPR were significantly positively correlated with the coronary artery Gensini scores in EH patients with UA(r=0.628,0.564,both P<0.05).Logistic regression analysis showed that median and high level of IL-18 and GPR were independently associated with UA in EH patients(OR=1.430,95%CI 1.158-2.132,P=0.011;OR=1.450,95%CI 1.255-2.882,P<0.001;OR=1.252,95%CI 1.132-2.011,P=0.015;OR=1.376,95%CI 1.210-2.132,P=0.006).Conclusions IL-18 and GPR are related to the severity of coronary stenosis.There is an interaction between UA and EH on the elevation of IL-18.High levels of IL-18 and GPR are independently associated with UA in EH patients.
作者
刘晓腾
张英
金凤表
刘慧卿
高宇
侯瑞田
LIU Xiao-teng;ZHANG Ying;JIN Feng-biao;LIU Hui-qing;GAO Yu;HOU Rui-tian(Department of Cardiac Electrophysiology,Hospital of Chengde Medical College,Chengde Hebei 067000,China;Department of Endocrinology,Affiliated,Hospital of Chengde Medical College,Chengde Hebei 067000,China)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2021年第1期48-53,共6页
Chinese Journal of Hypertension
基金
承德市技术研究与发展计划项目(201801A026)。
