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目的观察原发性高血压合并痛风患者血清脂联素(APN)及高敏C反应蛋白(hs-CRP)的变化并分析其临床意义。方法选择杭州市拱墅区中医医院2009年2月—2011年2月门诊或住院治疗的高血压并发痛风患者(A组,n=30),单纯痛风患者(B组,n=30)和单纯高血压患者(C组,n=30),同期选择健康体检者30例为对照组(D组)。详细测量、记录各组患者和健康体检者的血压、体质量、身高、腰围和臀围等资料,计算其腰臀围比和BMI等数据指标。各组患者及健康体检者抽取清晨空腹4 ml肘静脉血液,离心吸取血清后采用酶联免疫吸附法(ELISA)和免疫散射比浊法检测各组血清APN和hs-CRP的表达水平。对各组血清APN和hs-CRP表达水平的相关性予以分析。结果各组腰臀围比、BMI、血脂、血糖等指标相互比较,差异无统计学意义(P>0.05);与对照组[(7.41±1.20)mg/L,(2.83±0.88)mg/L]比较,A、B、C 3组血清APN[(3.45±0.86)mg/L,(4.57±0.95)mg/L,(4.42±1.23)mg/L]明显降低,hs-CRP明显升高[(8.47±3.15)mg/L,(7.19±2.40)mg/L,(6.61±2.57)mg/L](P<0.05);A、C2组血清APN表达水平与hs-CRP表达水平均呈负相关关系(P<0.05),而对照组血清APN与hs-CRP表达水平之间不存在明显相关性(P>0.05)。结论原发性高血压并发痛风患者血清脂联素下降,而炎症标志物hs-CRP明显升高,提示血清hs-CRP与原发性高血压并发痛风的发病有着密切相关性。
Objective To observe the changes of serum adiponectin (APN) and high-sensitivity C-reactive protein (hs-CRP) in patients with essential hypertension complicated with gout and to analyze its clinical significance. Methods The patients with hypertension complicated with gout (group A, n = 30), patients with simple gout (group B, n = 30) and simple patients with simple gout (group B) were selected from Gongshu District Traditional Chinese Medicine Hospital of Hangzhou City from February 2009 to February 2011 Hypertensive patients (C group, n = 30), the same period, 30 healthy subjects were selected as the control group (D group). Detailed measurement, record each group of patients and healthy subjects blood pressure, body mass, height, waist and hip circumference and other data to calculate the waist-hip ratio and BMI and other data indicators. Blood samples were collected from 4 mL of fasting cubital vein in each group of patients and healthy volunteers. Serum APN and hs-CRP levels were detected by enzyme-linked immunosorbent assay (ELISA) and immunostaining turbidimetry. The correlation between serum APN and hs-CRP expression levels in each group was analyzed. Results Compared with the control group [(7.41 ± 1.20) mg / L, (2.83 ± 0.88) mg / L, the waist circumference, hip circumference, BMI, blood lipid, blood glucose and other indicators were not significantly different between the two groups (P> 0.05) ], Compared with the control group, the serum levels of APN [(3.45 ± 0.86) mg / L, (4.57 ± 0.95) mg / L, (4.42 ± 1.23) mg / L] were significantly decreased and the hs- (8.47 ± 3.15) mg / L, (7.19 ± 2.40) mg / L, (6.61 ± 2.57) mg / L respectively]), while the levels of APN and hs-CRP in A and C2 groups were all negative (P <0.05). There was no significant correlation between serum APN level and hs-CRP level in the control group (P> 0.05). Conclusions Serum levels of adiponectin in patients with essential hypertension complicating with gout decrease but hs-CRP, a marker of inflammation, is significantly increased, suggesting that there is a close relationship between serum hs-CRP and the incidence of essential hypertension complicated by gout.