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目的探讨原发性高血压(essential hypertension,EH)伴动脉粥样硬化(atherosclerosis,AS)患者血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、血清淀粉样蛋白酶(serum amyloid A,SAA)、类胰蛋白酶(tryptase,TPS)、高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平变化及其危险因素。方法单纯高血压患者66例为对照组,EH伴AS患者57例为观察组,比较2组一般资料、血脂及Lp-PLA2、SAA、TPS、hs-CRP水平,分析其与EH伴AS形成的相关性。结果观察组吸烟比率(50.9%)、胆固醇[(4.60±0.95)mmol/L]、血清Lp-PLA2[(368.63±97.28)μg/L]、SAA[(1 102.72±240.24)mg/L]、TPS[(7.27±1.87)μg/L]、hs-CRP[(3.37±1.39)mg/L]水平高于对照组[25.8%、(4.08±0.81)mmol/L、(321.67±96.99)μg/L、(919.76±216.14)mg/L、(5.82±1.83)μg/L、(2.83±1.40)mg/L];logistic回归分析显示吸烟(OR=2.873,95%CI:1.106~7.466,P=0.030)、胆固醇>5.2mmol/L(OR=4.230,95%CI:1.113~16.071,P=0.034)、Lp-PLA2>311.075μg/L(OR=3.065,95%CI:1.196~7.860,P=0.020)、SAA>840.57 mg/L(OR=3.226,95%CI:1.125~9.254,P=0.029)、TPS>4.811μg/L(OR=12.335,95%CI:2.683~56.720,P=0.001)、hs-CRP>3mg/L(OR=3.558,95%CI:1.420~8.912,P=0.007)是EH伴AS发生的危险因素。结论吸烟及胆固醇、Lp-PLA2、SAA、TPS、hs-CRP水平增高是EH伴AS形成的危险因素,对其检测并及时干预在EH患者预防AS形成中有积极意义。
Objective To investigate the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and serum amyloid (Aβ) in patients with essential hypertension (EH) and atherosclerosis (AS) A, SAA, TPS and hs-CRP levels and their risk factors. Methods Sixty-six hypertensive patients were selected as the control group. Fifty-seven patients with EH accompanied with AS were selected as observation group. The levels of serum lipids, Lp-PLA2, SAA, TPS and hs-CRP were compared between two groups. Correlation. Results The smoking rate (50.9%), cholesterol (4.60 ± 0.95) mmol / L and serum Lp-PLA2 [(368.63 ± 97.28) μg / L] and SAA (102.72 ± 240.24 mg / L) The level of hs-CRP [(3.37 ± 1.39) mg / L] was higher than that of the control group [25.8%, 4.08 ± 0.81 mmol / L and 321.67 ± 96.99 μg / Logistic regression analysis showed that smoking (OR = 2.873, 95% CI: 1.106-7.466, P = 0.008, P = (OR = 3.030, 0.030), cholesterol 5.2 mmol / L (OR = 4.230, 95% CI 1.113-16.071, P = 0.034), Lp-PLA2 311.075 μg / 0.020), SAA> 840.57 mg / L (OR = 3.226,95% CI: 1.125-9.254, P = 0.029) and TPS> 4.811μg / , Hs-CRP> 3mg / L (OR = 3.558,95% CI: 1.420-8.912, P = 0.007) were the risk factors for EH with AS. Conclusions Smoking and cholesterol, Lp-PLA2, SAA, TPS and hs-CRP levels are risk factors for the development of AS in EH. It is of great significance to detect and timely intervention in prevention of AS in EH patients.