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目的探讨高血压患者血清抵抗素与颈动脉内膜中层厚度(IMT)及尿白蛋白排泄率(UAER)的关系。方法入选新发高血压患者100例和健康体检者30名,分别用ELISA法测定其血清抵抗素水平、超声诊断仪测量颈动脉IMT及化学发光法检测UAER。结果随着血压水平的升高,胰岛素抵抗指数(HOMA-IR)、血清抵抗素、颈动脉IMT及UAER水平逐渐增高(P<0·05)。以抵抗素中位数9·12μg/L分组,与低水平抵抗素组比较,高水平抵抗素组具有较高的颈动脉IMT[(0·92±0·20)比(0·63±0·15)mm,P<0·01]和UAER[(100·7±27·4)比(41·8±21·9)μg/min,P<0·01]。Pearson相关分析显示,抵抗素与收缩压、舒张压、HOMA-IR、低密度脂蛋白胆固醇、三酰甘油、高敏C反应蛋白、白细胞介素6、颈动脉IMT和UAER呈正相关(P<0·01)。在控制了年龄、血糖、HOMA-IR、血脂、高敏C反应蛋白、白细胞介素6、体质量指数、收缩压和舒张压后,抵抗素依然与颈动脉IMT和UAER呈正相关,偏相关系数分别为0·840和0·794(P<0·01)。多元线性回归分析显示UAER、收缩压和颈动脉IMT是抵抗素的独立影响因素。结论高血压患者血清抵抗素水平升高,颈动脉IMT和UAER与抵抗素呈独立正相关。
Objective To investigate the relationship between serum resistin and carotid artery intima-media thickness (IMT) and urinary albumin excretion rate (UAER) in patients with essential hypertension. Methods 100 cases of newly diagnosed hypertensive patients and 30 healthy subjects were enrolled in the study. Serum resistin levels were measured by ELISA, carotid artery IMT by ultrasound and UAER by chemiluminescence. Results With the increase of blood pressure, the levels of insulin resistance index (HOMA-IR), serum resistin, carotid artery IMT and UAER gradually increased (P <0.05). Compared with the low resistin group, the high resistin group had higher carotid IMT (0.92 ± 0.20) (0.63 ± 0.20), with a median resistin concentration of 9 · 12 μg / L · 15) mm, P <0.01, and UAER [(100.7 ± 27.4) vs. (41.8 ± 21.9) μg / min, P <0.01]. Pearson correlation analysis showed that there was a positive correlation between resistin and systolic blood pressure, diastolic blood pressure, HOMA-IR, LDL cholesterol, triglyceride, high sensitive C reactive protein, interleukin 6, carotid IMT and UAER (P < 01). Resistin was still positively correlated with carotid IMT and UAER after controlling for age, blood glucose, HOMA-IR, serum lipids, high-sensitivity C-reactive protein, interleukin 6, body mass index, systolic and diastolic blood pressure. Was 0. 840 and 0. 794 (P <0.01). Multivariate linear regression analysis showed that UAER, systolic blood pressure, and carotid IMT were independent risk factors for resistin. Conclusion Serum resistin levels are elevated in patients with hypertension, and carotid IMT and UAER are independently and independently correlated with resistin.