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目的探讨原发性高血压患者血清胱抑素C与臂踝动脉脉搏波传导速度(baPWV)的相关性。方法选取2014年5月至2015年10月山西医科大学第一医院高血压病区的原发性高血压患者234(男131、女103)例,年龄(56.5±12.0)岁。按血压水平将患者分为高血压1级、2级、3级组,另选取健康体检者187名作为对照组。检测baPWV、踝臂血压指数(ABI)、血清胱抑素C、血肌酐、空腹血糖、血脂及尿微量白蛋白水平;采用多元线性回归分析baPWV与胱抑素C的相关性。结果高血压1级、2级、3级组的baPWV高于对照组[(16.65±3.41)、(18.37±3.51)、(18.53±4.18)比(15.48±2.68)m/s,均P<0.05],高血压2级、3级组高于1级组(P<0.01)。高血压1级、2级、3级组血清胱抑素C高于对照组[(0.80±0.21)、(0.86±0.30)、(1.15±0.32)比(0.56±0.25)mg/L,均P<0.05],高血压3级高于1级、2级组(均P<0.05)。Pearson相关分析结果显示,baPWV与血清胱抑素C、年龄、收缩压、舒张压、心率、血糖呈正相关(分别r=0.357、0.605、0.479、0.184、0.227、0.150,均P<0.05),与BMI呈负相关(r=-0.235,P<0.01)。多元线性回归分析中校正各混杂因素后,发现胱抑素C仍是baPWV的影响因素(B=291.970,P<0.01)。结论原发性高血压患者血清胱抑素C与baPWV呈正相关。
Objective To investigate the relationship between serum cystatin C and arm-ankle pulse wave velocity (baPWV) in patients with essential hypertension. Methods A total of 234 patients (131 males and 103 females) with essential hypertension (56.5 ± 12.0 years) with hypertension in the First Hospital of Shanxi Medical University from May 2014 to October 2015 were selected. According to the level of blood pressure, the patients were divided into hypertension grade 1, grade 2 and grade 3, and 187 healthy subjects were selected as the control group. The baPWV, ABI, serum cystatin C, serum creatinine, fasting blood glucose, blood lipid and urine microalbumin were detected. The correlation between baPWV and cystatin C was analyzed by multivariate linear regression. Results The levels of baPWV in grade 1, 2 and 3 hypertension group were significantly higher than those in control group [(16.65 ± 3.41), (18.37 ± 3.51) and (18.53 ± 4.18) vs (15.48 ± 2.68) m / ], Grade 2 hypertension and grade 3 were higher than grade 1 (P <0.01). The serum levels of cystatin C in patients with grade 1, 2 and 3 hypertension were significantly higher than those in the control group [(0.80 ± 0.21), (0.86 ± 0.30), (1.15 ± 0.32) vs (0.56 ± 0.25) mg / L, <0.05], grade 3 hypertension was higher than grade 1 and grade 2 (all P <0.05). Pearson correlation analysis showed that baPWV was positively correlated with serum cystatin C, age, systolic blood pressure, diastolic blood pressure, heart rate and blood glucose (r = 0.357,0.605,0.479,0.184,0.227,0.150, all P <0.05) BMI was negatively correlated (r = -0.235, P <0.01). After adjusting for confounding factors in multiple linear regression analysis, it was found that cystatin C was still the influencing factor of baPWV (B = 291.970, P <0.01). Conclusions Serum cystatin C is positively correlated with baPWV in patients with essential hypertension.