H型高血压患者内皮脂肪酶和脂联素水平变化

摘要

目的：观察H型高血压患者血清内皮脂肪酶（EL）和脂联素（APN）水平变化，并探讨同型半胱氨酸（Hcy）与EL、APN及血脂的相关性。方法选择2014年1月~2015年2月在湖南医药学院第一附属医院确诊为原发性高血压的患者120例，男性77例，女性43例，年龄30～70（52.7±4.3）岁，其中H型高血压组患者90例。按血清Hcy浓度分为三组：Hcy＜10μmol/L为单纯高血压组（30例），Hcy 10～30μmol/L为轻度升高组（59例），Hcy 30～100μmol/L为中度升高组（31例）。另选择30例健康体检者作为对照组。所有入选者均检测Hcy、EL、APN、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）水平。结果 H型高血压组和单纯高血压组的TC、LDL-C、SBP、DBP与对照组比较均升高，差异具有统计学意义（P均＜0.01）。与对照组比较，H型高血压组和单纯高血压组血清EL水平升高，APN降低，差异有统计学意义（P均＜0.01）。H型高血压组较单纯高血压组的血清EL和Hcy升高，差异有统计学意义（P均＜0.01）。单纯高血压组、轻度升高组、中度升高组随着Hcy水平的升高，三组血清 EL水平也升高，差异有统计学意义（P均＜0.05）。相关分析结果显示，血清Hcy水平与EL、LDL-C呈正相关（r=0.397，P＜0.01；r=0.409，P＜0.01）。结论 H型高血压患者血清EL水平升高，APN水平降低，且EL随着Hcy升高而升高。%Objective To observe the changes of endothelial lipase (EL) and adiponectin (APN) in patients with H-type hypertension, and discuss the correlation between homocysteine (Hcy) and EL or APN.Methods The patients (n=120, male 77, female 43, aged from 30 to 70 and average age=52.7±4.3) were chosen from Jan. 2014 to Feb. 2015, and among them there were 90 patients with H-type hypertension (H-type hypertension group). The patients were divided again, according to serum Hcy level, into simple hypertension group (Hcy<10 μmol/L, n=30), mild decrease group (Hcy from 10 μmol/L to 30 μmol/L,n=59) and moderate decrease group (Hcy from 30 μmol/L to 100 μmol/L,n=31). Other 30 healthy controls were chosen as control group. The levels of Hcy, EL, APN, triglyceride (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and fasting plasma glucose (FPG) were detected in all groups.Results The levels of TC, LDL-C, SBP and DBP increased in H-type hypertension group and simple hypertension group compared with control group (allP<0.01). The level of EL increased and APN decreased in H-type hypertension group and simple hypertension group compared with control group (allP<0.01). The levels of EL and Hcy increased in H-type hypertension group compared with simple hypertension group (allP<0.01). The level of El increased as Hcy level increased in simple hypertension group, mild decrease group and moderate decrease group (allP<0.05). The results of correlation analysis showed that Hcy level was positively correlated to EL (r=0.397,P<0.01) and LDL-C (r=0.409, P<0.01).Conclusion The level of EL increases and APN level decreases in patients with H-type hypertension, and EL level will increase as Hcy level increases.