本文選題：原發(fā)性高血壓 + 血管內(nèi)皮功能　； 參考：《河北醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:本課題通過(guò)檢測(cè)原發(fā)性高血壓(Essential hypertension,EH)患者血清Chemerin水平,闡明血清Chemerin水平與血管內(nèi)皮功能的相關(guān)性。其中血管內(nèi)皮功能用高敏C反應(yīng)蛋白(High sensitivity C reactive protein,Hs CRP)、內(nèi)皮素-1(Endothelin-1,ET-1)及一氧化氮(Nitricoxide,NO)來(lái)評(píng)估。方法:本課題實(shí)驗(yàn)組收集2015年1月至2015年12月就診于河北醫(yī)科大學(xué)第二醫(yī)院門(mén)診為原發(fā)性高血壓的患者96例(男52例,女44例),高血壓入選患者參照《2013年中國(guó)高血壓防治指南》(修訂版)的診斷標(biāo)準(zhǔn)分為三個(gè)亞組:a組(高血壓1級(jí),共33例,男18例,女15例),b組(高血壓2級(jí),共38例,男20例,女18例),c組(高血壓3級(jí),共25例,男14例,女11例)。同時(shí)選取對(duì)照組32例(男18例,女14例),對(duì)照組均選自河北醫(yī)科大學(xué)第二醫(yī)院的體檢中心,體檢血壓正常,并記錄入選者的病史和各項(xiàng)生化指標(biāo)(包括Hs CRP)。采用酶聯(lián)免疫吸附的方法(ELISA)測(cè)定所有入選者血清Chemerin、ET-1水平,再采用硝酸還原酶法測(cè)定受試者血清、NO的水平。實(shí)驗(yàn)數(shù)據(jù)采用SPSS19.0統(tǒng)計(jì)軟件進(jìn)行分析,計(jì)量資料采用均數(shù)±標(biāo)準(zhǔn)差()表示,兩樣本比較若符合正態(tài)性應(yīng)用t檢驗(yàn),否則用Mann-Whitney U檢驗(yàn);多組間比較采用ANOVA法檢驗(yàn),若符合方差齊性,進(jìn)一步兩兩比較采用LSD檢驗(yàn),方差不齊時(shí)組間比較采用Gamees-Howell法;Hs CRP、ET-1及NO與Chemerin之間的相關(guān)性采用pearson法進(jìn)行相關(guān)分析;將Chemerin與具有相關(guān)意義的統(tǒng)計(jì)數(shù)據(jù)進(jìn)行多元逐步直線(xiàn)回歸分析。性別使用計(jì)數(shù)資料來(lái)表達(dá),比較采用卡方檢驗(yàn)。以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1與對(duì)照組相比,高血壓組Chemerin水平顯著高于對(duì)照組具有統(tǒng)計(jì)學(xué)差異(42.01±6.57 VS 117.93±4.89,P0.05);高血壓亞組內(nèi)各組Chemerin水平依次升高,具有統(tǒng)計(jì)學(xué)差異(128.10±20.30,180.63±18.44,239.59±31.86,P0.05)。2高血壓組Hs CRP水平顯著高于對(duì)照組具有統(tǒng)計(jì)學(xué)差異(2.92±0.74VS 4.29±0.97,P0.05);高血壓亞組內(nèi)Hs CRP水平無(wú)統(tǒng)計(jì)學(xué)差異(4.07±0.92,4.28±0.96,4.58±1.00,P0.05)。3高血壓組ET-1水平顯著高于對(duì)照組有統(tǒng)計(jì)學(xué)差異(41.12±11.24 VS90.56±20.34,P0.05);高血壓各組內(nèi)ET-1水平兩兩比較有統(tǒng)計(jì)學(xué)差異(77.32±15.68,87.89±13.07,112.13±17.60,P0.05)。4高血壓組NO水平顯著低于對(duì)照組有統(tǒng)計(jì)學(xué)差異(17.27±2.87 VS13.52±2.67,P0.05);高血壓各組內(nèi)NO水平比較c組低于b組及a組有統(tǒng)計(jì)學(xué)差異(10.00±1.71,14.38±1.53,15.19±1.67,P0.05),但b組與a組NO水平比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。5根據(jù)pearson相關(guān)分析表明:Chemerin水平與Hs CRP、ET-1水平呈正相關(guān)(相關(guān)系數(shù)r=0.225,r=0.561);Chemerin水平與NO水平呈負(fù)相關(guān)(相關(guān)系數(shù)r=-0.662);NO水平與ET-1水平呈負(fù)相關(guān)(r=-0.543)。結(jié)論:1與對(duì)照組相比,原發(fā)性高血壓組血清Chemerin水平增多,并隨血壓升高而增多。2原發(fā)性高血壓患者中血清Hs CRP水平及ET-1水平與Chemerin水平呈正相關(guān);NO水平與Chemerin水平呈負(fù)相關(guān)。3血清Chemerin與血管內(nèi)皮功能不全相關(guān),并且血管內(nèi)皮功能損傷程度越重,其血清水平越高,有可能成為反應(yīng)內(nèi)皮功能的新指標(biāo)。
[Abstract]:Objective: to elucidate the correlation between serum Chemerin level and vascular endothelial function by detecting serum Chemerin levels in patients with Essential hypertension (EH), and the vascular endothelial function was characterized by high sensitivity C reactive protein (High sensitivity C reactive protein, Hs), endothelin and nitric oxide. Methods: tricoxide, NO). Methods: the experimental group collected 96 cases of primary hypertension (52 males and 44 females) from January 2015 to December 2015 at the second hospital of Hebei Medical University (52 men and 44 women). The diagnostic criteria for hypertension prevention and control in China were divided into three subgroups: a group (high blood pressure) Pressure 1, a total of 33 cases, 18 men, 15 women, B group (38 cases of hypertension, 38 cases, 20 men, 18 women), group C (hypertension 3, 25 cases, male 14, 11 cases). Meanwhile, the control group was selected from the Hebei Medical University medical center, the physical examination was normal, and records the history and the students of the candidates of the medical history and the students of the selected candidates and the students recorded the history and the students of selected candidates and the students of the selected students and the students recorded the history and the entry of selected students and the students of the selected history and the students of selected candidates of the history and the students of selected candidates and the students of the selected students and the students recorded the history and the entry of selected students and the students of selected students and the students of the history and the entries of selected candidates of the history and the students selected students The index (including Hs CRP). The serum Chemerin and ET-1 levels were measured by enzyme linked immunosorbent assay (ELISA). The serum and NO levels of the subjects were measured by the nitrate reductase method. The experimental data were analyzed with the SPSS19.0 statistical software, and the measured data were measured with mean standard deviation (). The two samples were compared with the normal state. T test was used sex, otherwise Mann-Whitney U test was used; ANOVA test was used in multiple groups. If it was consistent with the homogeneity of variance, further 22 was compared with LSD test and Gamees-Howell method was used when the variance was not homogeneous; the correlation analysis between Hs CRP, ET-1 and NO and Chemerin was related with Pearson method. The statistical data of the significance were analyzed by multiple stepwise linear regression. The sex use count data were used to express and compare with chi square test. The difference of P0.05 was statistically significant. Results: 1 compared with the control group, the level of Chemerin in the hypertension group was significantly higher than that of the control group (42.01 + 6.57 VS 117.93 + 4.89, P0.05); The level of Chemerin in each group increased in turn, with statistical difference (128.10 + 20.30180.63 + 18.44239.59 + 31.86, P0.05), Hs CRP in.2 hypertension group was significantly higher than that of the control group (2.92 + 0.74VS 4.29 + 0.97, P0.05), and there was no statistical difference between the Hs CRP level in the subgroup of hypertension (4.07 + 0.92,4.28 + 1, 1). The ET-1 level in the blood pressure group was significantly higher than that in the control group (41.12 + 11.24 VS90.56 + 20.34, P0.05), and the ET-1 level 22 in the hypertension group was significantly different (77.32 + 15.68,87.89 + 13.07112.13 + 17.60, P0.05) and the NO level in the.4 hypertension group was significantly lower than that of the control group (17.27 + 2.87 VS13.52 + 2.67, P0.05). Compared with group B and group A, there was a statistical difference between group C and group B (10 + 1.71,14.38 + 1.53,15.19 + 1.67, P0.05), but there was no statistical difference between B and a groups (P0.05). Negative correlation (correlation coefficient r=-0.662), NO level and ET-1 level were negatively correlated (r=-0.543). Conclusion: 1 compared with the control group, the serum Chemerin level in primary hypertension group increased and the serum Hs CRP level and ET-1 level were positively correlated with the level of Chemerin in the patients with.2 primary hypertension; NO level and Chemerin level were related. The negative correlation.3 serum Chemerin is associated with vascular endothelial dysfunction, and the more the vascular endothelial dysfunction is, the higher the level of the serum, the higher the serum level, which may be a new indicator of endothelial function.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R544.11

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本文編號(hào)：1943130