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目的探讨氧化低密度脂蛋白(ox-LDL)与原发性高血压(EH)靶器官损害之间的关系。方法选择2006-10-2009-06在我科住院的1～3级EH患者182例[男性102例,女性80例,年龄(52.8±18.4)岁]作为研究对象,根据有无靶器官损害分为无靶器官损害组(n=85)和靶器官损害组(n=97)。所有患者均行心脏彩超检测并计算左室质量指数(LVMI)、颈动脉超声测量颈动脉内膜中层厚度(IMT)、测定24h尿微量白蛋白(UMA)并评估眼、脑损害。采用双抗体夹心ELISA法检测血清ox-LDL浓度,并评估ox-LDL对高血压靶器官损害的作用。结果有高血压靶器官损害的患者血浆ox-LDL浓度[(164.2±27.6)U/L]较无靶器官损害的患者增高[(114.6±24.3)U/L,P<0.01]。合并不同靶器官损害(LVMI,UMA,IMT,眼、脑损害)的病人的ox-LDL水平无区别。多元线性回归分析表明在校正年龄、性别、血脂、心率、身高、体质量指数、血糖、吸烟和药物治疗后,ox-LDL水平与LVMI、UMA、IMT及眼、脑损害密切联系,多元Logistic回归分析结果提示收缩压、ox-LDL、药物治疗、BMI与高血压靶器官损害密切相关(P<0.05或P<0.01)。结论ox-LDL水平升高与高血压靶器官损害明显相关,但是各种靶器官损害的病人的ox-LDL水平无差别,提示ox-LDL对靶器官损害无特异性。
Objective To investigate the relationship between oxidized low density lipoprotein (ox-LDL) and target organ damage in essential hypertension (EH). Methods A total of 182 EH patients (102 males and 80 females, aged 52.8 ± 18.4 years) who were hospitalized in our department from October 2006 to June 2009 were selected as study subjects. According to the presence or absence of target organ damage There was no target organ damage (n = 85) and target organ damage (n = 97). All patients underwent echocardiography and left ventricular mass index (LVMI), carotid artery stenosis (IMT), 24h urinary microalbuminuria (UMA) and eye and brain damage. The serum concentration of ox-LDL was measured by double antibody sandwich ELISA and the effect of ox-LDL on target organ damage in hypertension was evaluated. Results Compared with those without target organ damage, the plasma concentrations of ox-LDL [(164.2 ± 27.6) U / L] in patients with high blood pressure target organ damage [(114.6 ± 24.3) U / L, P <0.01]. There was no difference in ox-LDL levels between patients with different target organ damage (LVMI, UMA, IMT, ocular and brain lesions). Multivariate linear regression analysis showed that ox-LDL levels were closely related to LVMI, UMA, IMT and eye and brain damage after adjusting for age, sex, blood lipid, heart rate, height, body mass index, blood glucose, smoking and drug treatment. The results suggest that systolic blood pressure, ox-LDL, drug therapy, and BMI are closely related to target organ damage in hypertension (P <0.05 or P <0.01). Conclusions The elevated level of ox-LDL is significantly correlated with the target organ damage in hypertensive patients. However, there is no difference in the level of ox-LDL between the various target organ lesion patients, suggesting that ox-LDL has no specific target organ damage.