盐水负荷试验盐敏感者的大动脉弹性变化及其与C反应蛋白和单核细胞趋化蛋白1的相关性研究

目的 观察人群中盐敏感者的大动脉弹性变化及其与C反应蛋白、单核细胞趋化蛋白1的相关性。方法 选择原发性高血压患者64例以及正常对照组60例,通过口服盐水负荷试验及速尿缩容法将人群分别分为盐敏感者(SS)以及盐不敏感者(SR)。通过检测脉压指数、脉压、肱踝脉搏波传导速度(baPWV)作为大动脉弹性指标,使用ELISA法测定各组血清C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1),并观察其与大动脉弹性指标之间的相关性。结果 对照组中盐敏感者的脉压,baPWV明显高于盐不敏感者(61±18 vs 53±9 mmHg,t=7.71,P<0.05; 13.1±1.9 vs 11.9±2.8 m/s,t=3.65,P<0.05); 高血压组盐敏感者的脉压,baPWV亦高于盐不敏感者(71±15 vs 63±17 mmHg,t=13.86,P<0.05; 15.7±2.1 vs 14.3±1.8 m/s,t=4.04,P<0.05),差异均有统计学意义。对照组中盐敏感者的CRP,MCP-1水平高于盐不敏感者(6.89±2.75 vs 5.24±1.55 mg/L,t=22.02,P<0.05; 155.32±20.66 vs 100.11±10.75 pg/ml,t=75.97,P<0.05); 高血压组中盐敏感者的CRP,MCP-1水平亦高于盐不敏感者(8.28±3.61 vs 7.02±2.53 mg/L,t=21.86,P<0.05; 260.42±35.59 vs 200.18±45.17 pg/ml,t=63.72,P<0.05),差异均有统计学意义。CRP,MCP-1与脉压(r=0.451,0.374,P<0.05),baPWV(r=0.390,0.237,P<0.05)呈正相关性。结论 与盐不敏感者比较,盐敏感者的大动脉弹性降低,炎症反应可能参与了其大动脉弹性降低的过程。

Relation between C-reaction Protein,Monocyte Chemoattractant Protein1 and the Change of Arterial Elasticity in Salt Sensitivity Patients

Objective To investigate the change of arterialelasticity in salt sensitivity patients and relation between inflammatory factors level.Methods 60 healthy people and 64 mild to moderate hypertensive patients were recruited in this study.According to acute oral saline loading and furosemide volume-depletion tests,patients were divided intosalt-sensitive group(SS)and non-salt-sensitive group(SR).The serum C-reaction protein(CRP)and monocyte chemoattractant protein1(MCP-1)were measured by ELISA assay.Arterial elasticity was reflected by detecting pulse pressure(PP),pulse pressure index(PPI),ankle arteries-brachial artery pulse wave velocity(baPWV),and its relationship to CRP and MCP-1 were observed.Results In the coutrol group,pulse pressure(PP),ankle arteries-brachial artery pulse wave velocity(baPWV)were increased in SS group(61±18 vs53±9 mmHg,t=7.71,P<0.05; 13.1±1.9 vs 11.9±2.8 m/s,t=3.65,P<0.05),In the hypertension group,the PP and baPWV were increased in SS group(71±15 vs 63±17 mmHg,t=13.86,P<0.05; 15.7±2.1 vs 14.3±1.8 m/s,t=4.04,P<0.05).In the coutrol group,the CRP,MCP-1 were increased in SS group(6.89±2.75 vs 5.24±1.55 mg/L,t=22.02,P<0.05; 155.32±20.66 vs 100.11±10.75 pg/ml,t=75.97,P<0.05),In the hypertension group,the CRP and MCP-1 were increased in SS group(8.28±3.61 vs 7.02±2.53 mg/L,t=21.86,P<0.05; 260.42±35.59 vs 200.18±45.17 pg/ml,t=63.72,P<0.05).The serum CRP and MCP-1 were positively correlated with PP(r=0.451,0.374,P<0.05)and baPWV(r=0.390,0.237,P<0.05).Conclusion The arterial elasticity of SS was decreased compared with the SR,the increase of inflammatory factors may promote the arterial elasticity.