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目的：探讨联合检测血清中叶素（IM D）、胱抑素C（CysC）、成纤维细胞生长因子23（FGF23）与原发性高血压（E H）患者动脉粥样硬化（AS）的关系。方法选择E H患者60例（E H组）及健康体检者60例（对照组），应用高分辨二维超声技术测量颈动脉内膜中层厚度（cIMT）评估AS程度，采用酶联免疫吸附法（ELISA）测血清IM D、CysC及FGF23水平，同时检测相关生化指标。结果①E H组cIMT及血清IM D、CysC、FGF23水平高于对照组（P＜0．05）；②不同级别高血压患者cIMT及血清IM D、CysC、FGF23水平随血压分级升高而递增（P＜0．05）；③以cIMT为依据将患者分为cIMT正常组、cIMT增厚组及斑块形成组，血清IM D、CysC、FGF23水平随cIMT增厚而升高，3组患者血清IM D、CysC、FGF23水平比较，差异有统计学意义（P＜0．001）；④cIMT与IM D、CysC、FGF23呈正相关（r＝0．770、0．616、0．822，P＜0．001），进一步行非条件 Logistic 回归分析显示，收缩压（SBP）、IM D、CysC、FGF23、高密度脂蛋白（HDL）是cIMT增厚的独立危险因素（OR＝1．104、1．120、1．107、1．069、3．592，P＜0．05）。结论血清IM D、CysC及FGF23水平与血压分级和cIMT密切相关，是cIMT增厚的独立危险因素，三者可能参与了E H的发生发展，并影响AS的进程。联合检测E H患者血清IM D、CysC及FGF23水平可在一定程度上反映AS情况，为AS的防治提供新思路。“,”Objective To analyze the association between serum intermedin (IM D),Cystatin C (CysC)and fibroblast growth factor 23 (FGF23)with atherosclerosis (AS)in essential hypertensive (E H).Methods Serum IM D,CysC and FGF23 levels of 60 patients with E H(E Hgroup)and 60 healthy subjects (control group)were detected with en-zyme-linked immunosorbent assay (ELISA).The carotid intima media thickness (cIMT)was measured with UCG. Results The cIMT,serum IM D,CysC and FGF23 levels were significantly higher in E Hgroup than in control group (P<0.05).In E Hpatients,cIMT,serum IM D,CysC and FGF23 levels increased with elevated blood pressure levels (P<0.05).Based on the level of cIMT,all subjects were divided into normal cIMT group,thickened cIMT group and mottling formation group.The serum IM D,CysC and FGF23 levels in the three groups rose with cIMT,and the differ-ence had statistical significance (P<0.001 ).The cIMT level was positively correlated with serum IM D,CysC and FGF23 levels (r=0.770,0.616,0.822;P<0.001).When cIMT level was taken as the dependent variable,uncondi-tioned Logistic regression analysis showed that SBP,IM D,CysC,FGF23,and HDL were independent risk factors for cIMT (OR=1.104,1.120,1.107,1.069,3.592;P<0.05).Conclusion Serum IM D,CysC and FGF23 levels are closely associated with blood pressure classification and cIMT,indicating that they are independent risk factors of cI-MT.They may participate in the pathogenesis of E Hand affect the process of AS.Combined-detection of serum IM D, CysC and FGF23 can reflect the severity of AS and provide a new approach for its prevention and treatment.