老年原发性高血压患者肿瘤坏死因子-α与高敏C反应蛋白 同型半胱氨酸相关性分析

目的观察各级老年原发性高血压(EH)患者肿瘤坏死因子(TNF)-α、高敏C反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)的水平变化,以及TNF-α与hs-CRP、Hcy之间的相关性。方法分别测定39例各级老年EH患者血清TNF-α、hs-CRP和血浆Hcy水平以及血压和一般项目检查,以13名健康老年人作对照。结果①血清TNF-α和血浆Hcy水平在老年EH患者组明显高于老年对照组(P<0.01),且各级老年EH患者组间两两比较差异有统计学意义(P<0.01);血清hs-CRP水平在老年EH1级组升高不明显(P>0.05),在老年EH2级和3级组显著升高(P<0.01),且老年EH2级和3级组hs-CRP的水平与老年EH1级组比较差异有统计学意义(P<0.01)。②老年EH组TNF-α与hs-CRP(r=0.863,P<0.01)、Hcy(r=0.809,P<0.001)呈正相关。③以TNF-α为应变量,年龄、体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、hs-CRP、Hcy为自变量进行多元线性回归分析,TNF-α指标值的变化与hs-CRP和Hcy有线性回归关系,其中hs-CRP对TNF-α指标值影响最多。结论TNF-α、hs-CRP、Hcy浓度的升高,可能参与了老年原发性高血压发生的病理生理过程。TNF-α指标值的变化与hs-CRP和Hcy有线性回归关系,提示三者之间可能相互调节、相互作用,共同参与原发性高血压的病理生理过程。

Corrdation among tumor necrosis factor alpoha, high sensitivity C-reactive protein and homocysteine in senile essential hypertension pertensive patients

Objective To investigate the changes in serum levels of tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) in senile essential hypertension (EH) and the correlation among these three indicators. Methods Serum TNF-α, hs-CRP and plasma Hcy levels in 39 senile EH patients (with varied EH grades) were determined and compared to those in 13 healthy old adults as the control group. Serum TNF-α was determined by radioimmunoassay (RIA), serum hs-CRP by latex-enhanced immunoturbidimetry (LEITD) and plasma Hcy by fluorescence polarization immunoassay (FPIA). Results ① Serum TNF-α and plasma Hcy levels in all grades of senile EH were significantly lower than those in senile controls (P<0.01), with statistically significant differences across all senile EH groups (P<0.01). Changes in serum hs-CRP level was unremarkable in grade 1 senile EH (P>0.05), but was significant in grades 2 and 3 senile EH (P<0.01). Comparison on the level of hs-CRP in grades 2 and 3 senile EH with that in grade 1 senile EH showed statistical differences (P<0.01).② Pearson′s correlation analysis showed that TNF-α level was positively correlated with hs-CRP (r=0.863, P<0.01) and Hcy (r=0.809, P<0.01) in senile EH. ③ Multiple regression analysis showed that hs-CRP and Hcy were predictors to TNF-α levels in senile essential hypertensive group, especially the hs-CRP. Conclusion ① The levels of serum TNF-α, hs-CRP and plasma Hcy in senile essential hypertension were higher than those in senile normal controls. ② TNF-α level showed significantly positive correlation with hs-CRP and Hcy in senile essential hypertension, especially the hs-CRP.