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非糖尿病高血压患者动脉僵硬度增加及炎症与蛋白尿和左心室肥厚的关联

Association of increased arterial stiffness and inflammation with proteinuria and left ventricular hypertrophy in non-diabetic hypertensive patients.

作者信息

Tsai Wei-Chuan, Lin Chih-Chan, Huang Yao-Yi, Chen Ju-Yi, Chen Jyh-Hong

机构信息

Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Dou-Liou, Taiwan.

出版信息

Blood Press. 2007;16(4):270-5. doi: 10.1080/08037050701464443.

Abstract

OBJECTIVE

Both arterial stiffness and proteinuria are important markers for organ damage in hypertension. This study was planed to investigate the association between arterial stiffness and inflammation and to define the influences of proteinuria on arterial stiffness and inflammation in non-diabetic hypertension.

METHODS

We enrolled 205 patients (mean age 41 +/- 8 years, 66 women) with essential hypertension noted for less than 5 years in this study. They did not have diabetes mellitus or any overt cardiac, vascular, or renal complications. Stiffness index (SI) derived from digital volume pulse was used for assessment of arterial stiffness. High-sensitivity C-reactive protein (hsCRP) was measured in each patient during enrollment. Left ventricular hypertrophy (LVH) was documented by electrocardiography and proteinuria was assessed by measuring 24-h urine protein.

RESULTS

SI was significantly correlated with hsCRP (r = 0.166, p = 0.017). LVH was noted in 34 patients (17%). SI was significantly higher in patients with LVH (8.03 +/- 1.74 vs 7.19 +/- 1.19 m/s, p = 0.001). Proteinuria was noted in three patients with LVH. SI was gradually increased among patients without LVH, with LVH but not proteinuria, and with LVH and proteinuria (7.19 +/- 1.19, 7.68 +/- 1.21, 11.75 +/- 2.51 m/s respectively; p<0.001). HsCRP was also gradually increased among patients without LVH, with LVH but not proteinuria, and with LVH and proteinuria (0.20 +/- 0.24, 0.30 +/- 0.59, 1.56 +/- 1.58 mg/dl respectively; p<0.001).

CONCLUSIONS

SI was significantly correlated with hsCRP. Arterial stiffness and inflammation were increased in association with proteinuria in non-diabetic essential hypertension.

摘要

目的

动脉僵硬度和蛋白尿都是高血压患者器官损害的重要标志物。本研究旨在探讨动脉僵硬度与炎症之间的关联,并明确蛋白尿对非糖尿病高血压患者动脉僵硬度和炎症的影响。

方法

本研究纳入了205例原发性高血压患者(平均年龄41±8岁,女性66例),病程小于5年。他们无糖尿病,也无明显的心、血管或肾脏并发症。采用基于数字体积脉搏的僵硬度指数(SI)评估动脉僵硬度。入组时测定每位患者的高敏C反应蛋白(hsCRP)。通过心电图记录左心室肥厚(LVH),并通过测量24小时尿蛋白评估蛋白尿。

结果

SI与hsCRP显著相关(r = 0.166,p = 0.017)。34例患者(17%)存在LVH。LVH患者的SI显著更高(8.03±1.74 vs 7.19±1.19 m/s,p = 0.001)。3例LVH患者存在蛋白尿。在无LVH、有LVH但无蛋白尿、有LVH且有蛋白尿的患者中,SI逐渐升高(分别为7.19±1.19、7.68±1.21、11.75±2.51 m/s;p<0.001)。hsCRP在无LVH、有LVH但无蛋白尿、有LVH且有蛋白尿的患者中也逐渐升高(分别为0.20±0.24、0.30±0.59、1.56±1.58 mg/dl;p<0.001)。

结论

SI与hsCRP显著相关。在非糖尿病原发性高血压中,动脉僵硬度和炎症随蛋白尿增加而升高。

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