高血压病患者血清白细胞介素18和C反应蛋白与内皮功能的关系

目的研究高血压病患者血清白细胞介素18和C反应蛋白水平与内皮功能的关系。方法高分辨超声测定肱动脉血流介导的内皮依赖性血管舒张功能以无创性评价内皮功能,同时检测血清白细胞介素18和C反应蛋白水平;分析白细胞介素18、C反应蛋白与内皮依赖性血管舒张功能之间的关系。结果①与正常对照组比较,高血压病组血清白细胞介素18、C反应蛋白水平均显著增高,内皮依赖性血管舒张功能显著降低(P均<0.01)。高血压病组内比较,随高血压分级水平增高,内皮依赖性血管舒张功能渐行降低,而血清白细胞介素18及C反应蛋白水平均逐渐升高;内皮依赖性血管舒张功能正常亚组白细胞介素18、C反应蛋白水平均低于内皮依赖性血管舒张功能降低亚组(P均<0.01)。②直线相关分析显示,白细胞介素18、C反应蛋白水平均与内皮依赖性血管舒张功能呈直线负相关(P均<0.01)。③以内皮依赖性血管舒张功能为因变量进行多重逐步线性回归分析,调整其他相关危险因素的干扰后,白细胞介素18、C反应蛋白分别与内皮依赖性血管舒张功能的相关关系仍然存在(P均<0.01)。④以内皮依赖性血管舒张功能降低与否为因变量进行非条件Logistic逐步回归分析,筛选出白细胞介素18、C反应蛋白均为内皮依赖性血管舒张功能降低的独立危险因素。结论高血压病患者血清中白细胞介素18、C反应蛋白水平与内皮依赖性血管舒张功能之间存在显著的负相关,此相关性独立于其他相关危险因素;提示炎症可能参与了高血压病患者内皮功能障碍的发生与发展。

Associations of Interleukin-18 and C-Reactive Protein with Endothelial Function in Patients with Essential Hypertension

Aim To investigate the associations of serum interleukin-18 (IL-18) and C-reactive protein (CRP) with endothelial dysfunction in patients with essential hypertension. Methods Flow-mediated dilation (FMD) in right brachial artery was detected to reflect endothelial function by ultrasound. Serum IL-18 and CRP levels were also assayed. Bivariate correlation analysis was applied to show the correlation of serum IL-18 and CRP levels with FMD. Multiple linear regression was performed followed by unconditional logistic regression. Results The serum IL-18 and CRP levels were significantly higher in essential hypertension group than those in control group (P<0.01), but the FMD was significantly lower (P<0.01). In patients with essential hypertension, with the degree of blood pressure ascending, the serum IL-18 and CRP levels climbed gradually, but the FMD was descending (P<0.05). The serum IL-18 and CRP levels were significantly increased in FMD abnormal subgroup in comparison with those in FMD normal subgroup (P<0.01). Serum IL-18 and CRP levels were negatively correlated with FMD, respectively (P<0.01). In stepwise multiple linear regression model, after adjustion with other factors, the correlations of IL-18 and CRP levels with FMD persisted, respectively. The relationship between FMD and other study factors were analyzed by non-conditional logistic stepwise regression. Serum IL-18 and CRP levels were the important independent risk factors for FMD abnormal. Conclusions Serum IL-18 and CRP were negatively correlated with endothelial dysfunction in patients with essential hypertension, and the correlations persisted after adjustion with other factors, respectively. Serum IL-18 and CRP were the important independent risk factors for carotid artery plaque. The study suggests the link between inflammation and endothelial dysfunction in patients with essential hypertension.