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目的探讨老年高血压患者羧甲基赖氨酸(CML)和可溶性糖基化终产物受体(sRAGE)水平与血管硬化及左室舒张功能的关系。方法 84例老年高血压住院患者,采用ELISA法检测CML和sRAGE水平;用全自动动脉硬化测量仪测定动脉搏波传导速度(PWV);多普勒超声心动仪测量左心室舒张早期血流速度(E)、舒张晚期血流速度(A)及E/A,左心室舒张早期运动速度(Em)、晚期运动速度(Am)及Em/Am。结果单因素分析显示,PWV与年龄、CML、sRAGE呈正相关(P<0.05);E/A、Em/Am和年龄、CML、sRAGE均呈负相关(P<0.05)。多元回归分析显示,sRAGE与PWV、E/A、Em/Am无明显相关(P>0.05)。sRAGE与CML呈显著正相关(P<0.01)。结论老年高血压人群晚期糖基化终产物(AGEs)水平的升高影响血管硬化过程的同时也导致左室舒张功能下降;临床上可将降低AGEs水平作为减缓血管硬化的一种干预手段。
Objective To investigate the relationship between the levels of carboxymethyl lysine (CML) and soluble receptor for advanced glycation end products (sRAGE) in patients with senile hypertension and the relationship between vascular sclerosis and left ventricular diastolic function. Methods Eighty-four elderly inpatients with hypertension were enrolled in this study. The levels of CML and sRAGE were measured by ELISA. The PWV was measured with an automatic arteriosclerosis meter. The left ventricular diastolic blood flow (Doppler echocardiography) E), early diastolic velocity (A) and E / A, left ventricular diastolic velocity (Em), late diastolic velocity (Am) and Em / Am. Results Univariate analysis showed that PWV was positively correlated with age, CML and sRAGE (P <0.05). E / A and Em / Am were negatively correlated with age, CML and sRAGE (P <0.05). Multivariate regression analysis showed that there was no significant correlation between sRAGE and PWV, E / A, Em / Am (P> 0.05). There was a significant positive correlation between sRAGE and CML (P <0.01). Conclusions The increase of advanced glycation end products (AGEs) in elderly hypertensive patients may affect the process of vascular sclerosis as well as decrease the left ventricular diastolic function. Clinically, AGEs level may be an intervention to slow down the progression of vascular sclerosis.