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目的观察正常高值血压者单核细胞趋化因子1(MCP-1)mRNA的表达变化以及动脉结构和功能的改变,并探讨MCP-1与动脉僵硬度的相关性。方法 2010-03-05在山东省章丘农村进行调查,按血压水平选取理想血压者84例,正常高值血压者96例,高血压患者114例,采用实时荧光定量RT-PCR检测外周血中MCP-1mRNA表达,应用颈动脉超声检测颈动脉内膜中层厚度(IMT),并进行动态血压监测,计算动态动脉硬化指数(AASI)。结果理想血压组、正常高值血压组、高血压组外周血单个核细胞MCP-1mRNA表达量分别为(0.339±0.054),(0.411±0.038)和(0.525±0.052),两两比较,差异均有统计学意义(均P<0.01)。与理想血压组比较,正常高值血压组和高血压组颈动脉IMT[(0.79±0.05),(0.89±0.08)比(0.70±0.07)mm]及AASI[(0.58±0.05),(0.64±0.05)比(0.45±0.05),均P<0.01]均增高;与正常高值血压组比较,高血压组颈动脉IMT及AASI均增高(均P<0.01)。Pearson相关分析显示MCP-1与颈动脉IMT、AASI均呈正相关(r=0.475,0.440,均P<0.01)。控制多种危险因素后,偏相关分析显示MCP-1与颈动脉IMT、AASI均呈正相关(r=0.371,0.272,均P<0.01)。多元线性逐步回归分析显示,MCP-1、收缩压和年龄是颈动脉IMT和AASI的独立危险因素。结论正常高值血压者动脉僵硬度增加,MCP-1mRNA表达水平升高,动脉硬化程度与MCP-1mRNA表达水平呈正相关,提示MCP-1mRNA表达水平升高参与了正常高值血压者动脉硬化的病理生理过程。
Objective To observe the expression of monocyte chemoattractant factor-1 (MCP-1) mRNA and the changes of arterial structure and function in patients with normal high blood pressure and to explore the relationship between MCP-1 and arterial stiffness. METHODS: Totally 84 patients with ideal blood pressure were selected according to the blood pressure level in 96 villages in Zhangqiu County, Shandong Province. 96 patients with normal high blood pressure and 114 patients with hypertension were measured by real-time fluorescence quantitative RT-PCR. The expression of MCP-1mRNA, the carotid artery intima-media thickness (IMT) were measured by carotid artery ultrasonography and the dynamic arterial pressure was measured. The dynamic arteriosclerosis index (AASI) was calculated. Results The expression of MCP-1 mRNA in peripheral blood mononuclear cells of ideal blood pressure group, normal high blood pressure group and high blood pressure group were (0.339 ± 0.054), (0.411 ± 0.038) and (0.525 ± 0.052), respectively There was statistical significance (all P <0.01). Compared with ideal blood pressure group, carotid IMT (0.79 ± 0.05), (0.89 ± 0.08) and (0.70 ± 0.07) mm] and AASI [(0.58 ± 0.05) and (0.64 ± 0.05) than that in the control group (0.45 ± 0.05), all P <0.01]. Compared with the normal high blood pressure group, the carotid IMT and AASI in the hypertension group were significantly increased (all P <0.01). Pearson correlation analysis showed that there was a positive correlation between MCP-1 and carotid IMT, AASI (r = 0.475,0.440, all P <0.01). After controlling a variety of risk factors, partial correlation analysis showed that there was a positive correlation between MCP-1 and carotid IMT and AASI (r = 0.371,0.272, all P <0.01). Multivariate linear stepwise regression analysis showed that MCP-1, systolic blood pressure, and age were independent risk factors for carotid IMT and AASI. CONCLUSIONS: Arterial stiffness increased, MCP-1 mRNA expression increased, and atherosclerosis was positively correlated with MCP-1 mRNA expression in normal high blood pressure, suggesting that the increased expression of MCP-1 mRNA may be involved in the pathogenesis of arteriosclerosis in patients with normal high blood pressure Physiological process.