發(fā)布時(shí)間：2018-06-08 02:13

  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)》2017年碩士論文

【摘要】：目的:探究原發(fā)性高血壓(EH)患者血清補(bǔ)體C1q腫瘤壞死因子相關(guān)蛋白5(CTRP5)水平變化,并分析其與血管內(nèi)皮(VEC)功能的相關(guān)性。方法:本課題實(shí)驗(yàn)組收集2016年1月至2016年12月就診于河北醫(yī)科大學(xué)第二醫(yī)院門診的原發(fā)性高血壓患者84例(男43例,女41例),入選患者參照《2013年中國高血壓防治指南》(修訂版)的診斷標(biāo)準(zhǔn)分為三個(gè)亞組:1組(高血壓1級(jí),共26例,男12例,女14例),2組(高血壓2級(jí),共28例,男16例,女12例),3組(高血壓3級(jí),共30例,男15例,女15例)。同時(shí)選取對照組44例(男20例,女24例),對照組均選自河北醫(yī)科大學(xué)第二醫(yī)院的體檢中心,體檢血壓正常。記錄入選者病史和各項(xiàng)生化指標(biāo)(包括高敏C反應(yīng)蛋白,HsCRP)。應(yīng)用硝酸還原酶法測定血清一氧化氮(NO)的水平,應(yīng)用酶聯(lián)免疫吸附的方法(ELISA)測定血清CTRP5、內(nèi)皮素(ET-1)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),否則應(yīng)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;CTRP5與HsCRP、ET-1及NO之間的相關(guān)性分析采用pearson法;性別使用計(jì)數(shù)資料來表達(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實(shí)驗(yàn)組CTRP5水平高于對照組,具有統(tǒng)計(jì)學(xué)差異(138.40±20.74ng/ml VS 106.37±9.53ng/ml,P0.05);實(shí)驗(yàn)組組內(nèi)兩兩比較有統(tǒng)計(jì)學(xué)差異(124.08±16.96ng/ml,134.71±16.08ng/ml,154.26±16.88ng/ml,P0.05)。2實(shí)驗(yàn)組HsCRP水平顯著高于對照組具有統(tǒng)計(jì)學(xué)差異(4.26±3.48mg/LVS 3.11±2.80mg/L,P0.05);實(shí)驗(yàn)組組內(nèi)HsCRP水平3組高于1組及2組有統(tǒng)計(jì)學(xué)差異(3.19±2.80mg/L,3.77±2.72mg/L,5.65±4.21mg/L,P0.05),但1組與2組HsCRP水平無統(tǒng)計(jì)學(xué)差異(P=0.50)。3實(shí)驗(yàn)組ET-1水平顯著高于對照組有統(tǒng)計(jì)學(xué)差異(75.56±20.33ng/LVS 26.87±3.98ng/L,P0.05);實(shí)驗(yàn)組組內(nèi)兩兩比較有統(tǒng)計(jì)學(xué)差異(58.20±6.81ng/L,73.33±11.98ng/L,93.42±20.09ng/L,P0.05)。4實(shí)驗(yàn)組NO水平顯著低于對照組有統(tǒng)計(jì)學(xué)差異(13.57±1.95umol/L VS31.83±6.69umol/L,P0.05);實(shí)驗(yàn)組組內(nèi)NO水平兩兩比較有統(tǒng)計(jì)學(xué)差異(11.45±0.71umol/L,13.74±1.09umol/L,15.83±0.25umol/L,P0.05)。5根據(jù)pearson相關(guān)分析表明:CTRP5水平與HsCRP、ET-1水平呈正相關(guān)(相關(guān)系數(shù)r=0.273,P0.05;相關(guān)系數(shù)r=0.696,P0.05);CTRP5水平與NO水平呈負(fù)相關(guān)(相關(guān)系數(shù)r=-0.639,P0.05);NO水平與ET-1水平呈負(fù)相關(guān)(r=-0.796,P0.05)。結(jié)論:1血清CTRP5水平可以提示原發(fā)性高血壓患者血管內(nèi)皮功能的損傷程度,并有可能可以成為評價(jià)血管內(nèi)皮功能的另一標(biāo)志物。2血清CTRP5有可能成為心血管疾病的生物學(xué)標(biāo)志物及治療靶點(diǎn)。
[Abstract]:Aim: to investigate the changes of serum complement C1q tumor necrosis factor-associated protein 5 (CTRP5) in patients with essential hypertension (EH) and to analyze its correlation with vascular endothelial cell (VEC) function. Methods: from January 2016 to December 2016, 84 patients (43 males) with essential hypertension in the outpatient clinic of the second Hospital of Hebei Medical University were collected. According to the diagnostic criteria of the Chinese guidelines for the Prevention and treatment of Hypertension in 2013 (revised edition), 41 female patients were divided into three subgroups: group 1 (26 cases of grade 1 hypertension, 12 males and 14 females) (grade 2 hypertension, 28 cases, male 16 cases). There were 30 cases of hypertension, 15 cases of male and 15 cases of female. At the same time, 44 cases of control group (20 males and 24 females) were selected from the physical examination center of the second Hospital of Hebei Medical University. The blood pressure of the physical examination was normal. The history and biochemical parameters (including Gao Min C reactive protein) of the selected patients were recorded. Serum nitric oxide (no) was determined by nitrate reductase method and serum CTRP5 and endothelin ET-1 (et 1) by enzyme linked immunosorbent assay (Elisa). The experimental data were analyzed by SPSS 19.0 statistical software, and the measurement data were expressed by mean 鹵standard deviation. If the two samples were in accordance with normal test, otherwise Mann-Whitney U test would be used, and the multigroup comparison would be tested by ANOVA method. If coincident with homogeneity of variance, further pairwise comparison was carried out by LSD test, and Gamees-Howell method was used to analyze the correlation between CTRP5 and HsCRPnET-1 and no, and the data of sex use counting was used to express it, and chi-square test was used to compare the data. P0.05 as the difference was statistically significant. Results the level of CTRP5 in the experimental group was higher than that in the control group. There was statistical difference between the experimental group (138.40 鹵20.74ng/ml vs 106.37 鹵9.53ng / ml P0.05) and the experimental group (124.08 鹵16.96ng / ml vs 134.71 鹵16.08ng / ml / ml = 154.26 鹵16.88ng / ml / ml P 0.05.2 vs 4.26 鹵3.48mg / L vs 3.11 鹵2.80mg / L P0.05N respectively); the level of HsCRP in the experimental group was significantly higher than that in group 1 and group 2 (P < 0.05); the level of HsCRP in experimental group was significantly higher than that in group 1 and group 2 (P < 0.05). 3.19 鹵2.80 mg / L = 3.77 鹵2.72 mg / L = 5.65 鹵4.21 mg / L P 0.05, but there was no significant difference in HsCRP level between group 1 and group 2. The level of ET-1 in experimental group was significantly higher than that in control group (75.56 鹵20.33ngLVS 26.87 鹵3.98ngL / L P 0.05N), and the level of no in experimental group was significantly lower than that in control group (58.20 鹵6.81ngLP / P 73.33 鹵11.98ngL / L 93.42 鹵20.09ngL / L = 0.05.4). The statistical difference was 13.57 鹵1.95umoll / L VS31.83 鹵6.69umoll / L P 0.05g / L and 11.45 鹵0.71umoll / L / L = 13.74 鹵1.09umolol / L = 15.83 鹵0.25umolr / L P 0.05.5 according to pearson correlation analysis, there was a positive correlation between the level of CTRP5 and the level of HsCRPnET-1 (r = 0.273g / L, P 0.05; r = 0.696P 0.05P = 0.05; r = 0.696P 0.05g / L = 13.74 鹵1.09umolol / L = 15.83 鹵0.25umolr / L P 0.05.5). According to pearson correlation analysis, the correlation between the level of CTRP5 and the level of HsCRPt-1 was positively correlated. There was a negative correlation between the level of no and the level of ET-1. Conclusion the serum CTRP5 level in the patients with essential hypertension may indicate the degree of injury of vascular endothelial function in patients with essential hypertension. Serum CTRP5 may be a biomarker and therapeutic target for cardiovascular diseases.
【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】：2017
【分類號(hào)】：R544.11

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本文編號(hào)：1993930