老年高血压人群高敏C反应蛋白增高与新发心脑血管事件的关系

摘要

目的 探讨血清高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)增高对老年高血压人群新发心脑血管事件的影响.方法 选择我院健康体检、年龄60~80岁的老年高血压人群5021例,行血清hs-CRP检测,从hs-CRP 0~5 mg/L 3321例中随机选500例为正常组;从hs-CRP＞5 mg/L且≤10 mg/L的1700例中随机选500例为增高组.随访3年,随访期每6个月收集1次新发心脑血管事件情况.比较新发心脑血管事件发生率.结果 增高组新发心脑血管事件、脑梗死、非致死性急性心肌梗死发生率明显高于正常组,差异有统计学意义(14.4% vs 8.0%,7.0% vs 3.8%,5.2% vs 2.6%,P<0.05,P<0.01).增高组累计无事件生存率明显低于正常组,随时间延长而逐渐明显,至随访3年结束时,生存率比较差异有统计学意义(P<0.05).Cox比例风险回归分析显示,hs-CRP是心脑血管事件发生的独立危险因素,风险比3.67.结论 hs-CRP水平增高的老年高血压人群发生临床心脑血管事件的危险增加,尤其是脑梗死和心肌梗死的危险.%Objective To study the effect of hs-CRP on first cardio-cerebral vascular events in elderly hypertensive patients .Methods Five thousand and twenty-one 60 80 years old hypertensive patients who underwent hs-CRP test were included in this study .Five hundred out of the 3321 patients with their hs-CRP being 0 5 mg/L served as a normal hs-CRP group and 500 out of the 1700 patients with their hs-CRP >5 mg/L but ≤10 mg/L served as a high hs-CRP group .The patients were followed up for 3 years during which the incidence of first cardio-cerebral vascular events was recorded every 6 months and compared .Results The incidence of first cardio-cerebral vascular events ,cerebral infarction and non-fetal myocardial infarction was significantly higher in high hs-CRP group than in normal hs-CRP group (14 .4% vs 8 .0% ,7 .0% vs 3 .8% ,5. 2% vs 2. 6% ,P<0 .05 ,P<0 .01) .The accumulated events-free survival rate was lower in high hs-CRP group than in normal hs-CRP group at the end of 3-year follow-up ( P<0. 05 ). Cox regression analysis showed that hs-CRP was the independent risk factor for cardio-cerebral vascular events . Conclusion The risk to occur cardio-cerebral vascular events ,especially cerebral and myocardial infarction increases in elderly hypertensive patients with a high hs-CRP level.