血清PTX-3、PGRN与合并OSAHS的高血压病患者血压变异性的关系

目的探讨血清正五聚蛋白3(PTX-3)、颗粒蛋白前体(PGRN)与合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的高血压病患者血压变异性的关系。方法选取241例高血压病合并OSAHS患者,根据呼吸暂停低通气指数(AHI),将患者分成轻度组(n=136)、中度组(n=45)和重度组(n=60)。比较三组患者血清指标和血压变异性的差异,应用Pearson分析血清PTX-3和PGRN水平与血压变异性的相关性,线性回归分析血压变异的危险因素。结果合并不同程度OSAHS患者夜间血压变异性各指标差异有统计学意义(P<0.05);三组患者血清PTX-3和PGRN水平差异有统计学意义(P<0.05);血清PTX-3与夜间收缩压标准差(nSSD)(r=0.484,P<0.001)和夜间舒张压标准差(nDSD)呈正相关(r=0.349,P<0.001);血清PGRN与nSSD(r=0.361,P<0.001)和nDSD呈正相关(r=0.301,P<0.001)。PTX-3和PGRN增加是nSSD、nDSD升高的危险因素(P<0.05)。结论血清PTX-3和PGRN与高血压病合并OSAHS患者夜间血压变异性呈正相关,并且二者表达升高是夜间血压变异增加的危险因素。

The correlation serum PTX-3, PGRN with blood pressure variability in essential hypertension patients combined with obstructive sleep apnea hypopnea syndrome

Aim To explore relationship between serum pentraxin 3(PTX-3), progranulin(PGRN) and blood pressure variability in essential hypertension patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 241 cases of essential hypertension patients with OSAHS were selected as the observation subjects. According to the apnea hypopnea index(AHI) (mild:AHI 5~15 times/h; moderate:AHI 16~0 times/h; severe:AHI>31 times/h), the patients were divided into mild group (n=136), moderate group (n=45) and severe group (n=60). The baseline data, serum PTX-3 and PGRN, blood pressure variability and the correlation between serum factors and blood pressure variability were compared and analyzed. Pearson and muti-line regression were employed to analyse the relationship between PTX-3, PGRN and blood pressure variability. Results There were significant differences in serum PTX-3 and PGRN levels among the three groups (P<0.05), and there were significant differences in night blood pressure variability among the three groups (P<0.05). Serum PTX-3 was positively correlated with night systolic blood pressure standard deviation(nSSD) (r=0.484, P<0.001) and night diastolic blood pressure standard deviation(nDSD) (r=0.349, P<0.001). Serum PGRN was positively correlated with nSSD (r=0.361, P<0.001) and nDSD (r=0.301, P<0.001). PTX-3 and PGRN were independent risk factors for nSSD and nDSDD. Conclusion Serum PTX-3 and PGRN were positively correlated with nocturnal blood pressure variability in essential hypertension patients with OSAHS. Serum level of PTX-3 and PGRN were independent risk factors of nocturnal blood pressure variability.