Objective To explore the relationship high sensitive C - reactive protein ( hs - CRP ) with blood pressure ( BP ) and BP variability ( BPV ) in patients with essential hypertension. Methods A total of 178 hypertensive outpatients and inpatients of our hospital between October 2011 and June 2012 were included. 24 h ambulatory blood pressure monitoring was conducted. Plasma level of hs - CRP, fasting blood glucose and lipids were also examined. Patients were grouped into quartiles according to hs - CRP level. Average BP and standard deviation ( SD, as the index of BPV ) in different time intervals ( 24 -hour, daytime, nighttime ) were compared among four groups. The correlations between hs - CRP and BP or BPV were analyzed with multiple linear regression. Results Compared to the lowest quartile of hs - CRP, systolic and diastolic BPV were significant higher in the highest quartile during the nighttime ( P <0. 05 ). By contrast, there was no difference in mean BP among the hs - CRP quartile groups during any of the time periods ( P > 0. 05 ). Multiple linear regression models revealed that nighttime SBP - SD ( β = 0. 228 , P < 0. 01 ) and high density lipoprotein cholesterol (β= - 0. 190, P < 0. 05 ) were significantly related to hs - CRP. Conclusion Hs - CRP is closely related with BPV in hypertensive patients, suggesting that inflammation may be one of the mechanisms underlying the link between BPV and target organ damage.%目的 探讨原发性高血压患者血压水平及血压变异性(BPV)与超敏C-反应蛋白(hs-CRP)的关系.方法 对2011年10月-2012年6月在我院神经内科门诊就诊或住院的高血压患者共178例监测24 h动态血压,测定血清hs-CRP和血脂等生化指标.根据hs-CRP四分位值将患者分为4组,比较24 h、日间和夜间时段的血压均值及标准差(SD,以SD作为BPV的指标).hs-CRP与不同时段的血压、SD等自变量的相关性采用多元线性逐步回归分析.结果 与hs-CRP第1四分位组相比,夜间收缩压SD(SBP-SD)在第4四分位组明显增高,舒张压SD(DBP-SD)在第4四分位组也明显增高,差异均有统计学意义(P＜0.05),而各时段的收缩压和舒张压在各四分位组差异均无统计学意义(P＞0.05).多元线性逐步回归分析显示夜间SBP-SD(β=0.228,P＜0.01)及高密度脂蛋白胆固醇(β=-0.190,P＜0.05)与hs-CRP独立相关.结论 高血压患者BPV与炎性因子hs-CRP密切相关,提示炎症可能是BPV致靶器官损害的主要机制之一.
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