老年原发性高血压患者TNF-a、IL-6水平与血压、颈动脉粥样硬化的关系

目的研究老年原发性高血压患者血清TNF—a、IL-6与血压、颈动脉粥样硬化的关系。方法选择218例老年高血压患者，男166例、女52例，平均年龄（78．45±3．14）岁，应用颈动脉超声测量颈动脉内膜一中膜厚度（intima—mediamickness，IMT），观察有无斑块形成，并对颈动脉粥样硬化程度用硬化斑块指数（plaqueindex，PI）进行分级，用免疫学方法测定血清中TNF-a、IL-6的浓度。结果随着高血压级别升高，IMT越厚，TNF-a、IL-6浓度越高，不同级别间IMT、TNF-a、IL-6的差别有统计学意义（P〈0．05）；合并颈动脉粥样硬化的老年高血压患者血清TNF-a、IL-6的含量明显高于无颈动脉硬化患者（P〈0．05）；有颈动脉斑块的患者血清TNF-a、IL-6的含量明显高于颈动脉内中膜增厚及内中膜正常患者（P〈0．05和P〈0．01）；随着颈动脉PI级别增加，TNF-a、IL-6的浓度逐渐增高，颈动脉PI各级别之间比较差异均有统计学意义（P〈0．05和P〈0．01）。结论TNF-a、IL-6参与高血压患者颈动脉粥样硬化的发生发展过程。降低TNF—a、IL-6水平，抑制炎症反应可能阻止高血压及动脉粥样硬化的发展。

Relationship of serum TNF-a and IL-6 levels with blood pressure and carotid atherosclerosis in elderly patients with essential hypertension

Objective To investigate the relationship of serum TNF-a and IL-6 levels with blood pressure and carotid atherosclerosis in elderly patients with essential hypertension. Methods Totally 218 elderly patients with essential hypertension diagnosed according to WHO/ISH standard were enrolled in the study. Intima-media thickness （IMT） and plaque formation in common carotid artery were examined by Doppler color ultrasonography and the degree of carotid atherosclerosis was classified by plaque index （PI）. Serum TNF-a and IL-6 were measured. Results The thickness of IMT and serum TNF-a and IL-6 levels were increased with the elevation of blood pressure in hypertensive patients （P 〈 0. 05 ）. Serum TNF-a and IL-6 levels were significantly higher in hypertensive patients with carotid atherosclerosis （CA） than those without CA （ P 〈 0.05 ）. Serum TNF-a and IL-6 levelswere higher in patients with carotid plaques than those of increased IMT and normal IMT （ P 〈 0. 05 and P 〈 0.01 ） ; and increased with the increasing of carotid artery PI （ P 〈 0. 05 ）. Conclusion Serum TNF-aand IL-6 levels are associated with carotid atherosclerosis in elderly patients with hypertension, indicating that inhibition of inflammatory response may prevent artery atherosclerosis in hypertensive patients.