原发性高血压合并2型糖尿病患者Fibulin-3与肱-踝脉搏波传导速度的相关性

摘要

目的 探讨原发性高血压合并2型糖尿病患者血清Fibulin-3水平和肱-踝脉搏波传导速度(branchial-ankle pulse wave velocity,baPWV)的相关性及临床意义.方法 以55例原发性高血压合并2型糖尿病患者(病例组)、62例原发性高血压患者(对照组)及35例健康人(正常组)为研究对象,以酶联免疫吸附(ELISA)法检测血清Fibulin-3、乳胶免疫比浊法检测超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、放射免疫(RIA)法检测血管紧张素Ⅱ(angiotensinⅡ,AngⅡ);脉搏波速度自动测定仪测定baPWV.结果 Fibulin-3水平病例组[(40.92±21.84)ng/mL]低于对照组[(52.61±27.24)ng/mL]和正常组[(68.00±29.62)ng/mL],3组间比较,差异有统计学意义(P＜0.05).病例组hs-CRP、AngⅡ和baPWV水平高于对照组和正常组[(5.96±2.93)mg/L vs(2.63±1.92)mg/L vs(1.22±0.71)mg/L;(55.28±4.97)ng/L vs(50.29±5.59)ng/L vs(47.39±3.05)ng/L;(1 870.33±371.16)cm/s vs(1 706.11±361.68)cm/s vs(1 535.34±253.83)cm/s],差异有统计学意义(P＜0.05).Fibulin-3与baPWV、hs-CRP和AngⅡ均呈负相关(r=-0.420,P=0.029;r=-0.570,P=0.011;r=-0.586,P=0.013).结论 原发性高血压合并2型糖尿病患者的动脉硬化程度更高,Fibulin-3参与动脉硬化的过程与炎性反应密切相关,进一步研究其中的作用机制有助于延缓动脉硬化及靶器官损害.%Objective To investigate the correlation between Fibulin-3 and the branchial-ankle pulse wave velocity (baPWV) in patients with essential hypertension and type 2 diabetes mellitus (T2 DM). Methods A total of 55 patients with essential hypertension and T2 DM (case group), 62 patients with essential hypertension (control group) and 35 healthy individuals (normal group) were included. Serum levels of Fibulin-3, hs-CRP, and AngII were measured by enzyme-linked immunosorbent assay, latex immunoturbidimetry, and radio immunoassay methods, respectively. The baPWV was measured by the automatic pulse wave velocity meter. Results The serum level of Fibulin-3 in the case group was significantly lower than those in the control group and the normal group [ (40.92±21.84) ng/mL vs. (52.61±27.24) ng/mL and (68.00±29.62) ng/mL, P＜0.05]. The levels of hs-CRP, AngII and baPWV in the case group were significantly higher than those in the control group and the normal group [ (5.96±2.93) ng/L vs. (2.63±1.92) ng/L and (1.22±0.71) ng/L; (55.28±4.97) ng/L vs. (50.29±5.59) ng/L and (47.39±3.05) ng/L; (1 870.33±371.16) cm/s vs. (1 706.11±361.68) cm/s and (1 535.34±253.83) cm/s; P＜0.05]. Fibulin-3 was significantly negatively correlated with baPWV (r=-0.420, P=0.029), hs-CRP (r=-0.570, P=0.011) and AngII (r=-0.586, P=0.013). Conclusion The degree of arteriosclerosis is higher in patients with essential hypertension and T2 DM. Fibulin-3 is involved in the process of vascular remodeling and closely related to inflammation. Further study of its mechanism may help to delay the arteriosclerosis process and target organ damage.