老年高血压病患者血清Hcy与细胞因子的相关性研究

Correlation between serum Hcy and cytokines in patients with elderly hypertension

摘要:

目的：研究老年高血压病患者血清同型半胱氨酸（homocysteine，Hcy）与肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素-6（interleukin-6，IL-6）、血浆内皮素（endothelin，ET）、一氧化氮（nitric oxide，NO）的改变及其之间的相关性，从免疫炎症因子、血管内皮因子角度探讨Hcy在老年高血压病中的作用机制。方法：测定177例老年高血压病患者血清Hcy、TNF-α、IL-6、ET、NO，根据血清Hcy浓度分为Q1组、Q2组、Q3组，用单因素方差分析3组间指标参数差异。采用Pearson相关性分析Hcy与各指标之间的相关性。并用二项logistic回归分析血清Hcy对TNF-α、IL-6、ET、NO的具体影响。结果：①Q2、Q3组Hcy、TNF-α、IL-6、ET均较Q1组明显升高而NO明显降低（均P<0.05）；②Pearson相关分析显示，Hcy与TNF-α、IL-6、ET呈正相关（r=0.676、0.852、0.730），与NO呈负相关（r=-0.637）；③校正其他影响因素后，logistic回归分析显示Hcy是TNF-α、IL-6、ET升高的危险因素（均P<0.05），但是NO升高的保护因素（P<0.05）。结论：老年高血压病患者血清Hcy与TNF-α、IL-6、ET、NO具有相关性，高Hcy可能导致免疫炎症损伤、血管内皮功能紊乱，进而参与老年高血压病的病理过程。

Abstract:

Objective：To investigate the change between serum homocysteine（Hcy） and tumor necrosis factor-α（TNF-α），inter－leukin-6（IL-6），plasma endothelin（ET） and nitric oxide（NO） in patients with elderly hypertension and their correlation，and to investigate the mechanism of Hcy in the elderly hypertension from the perspective of immune inflammatory factor and vascular endothelial factor. Methods：The serum Hcy，TNF-α，IL-6，ET and NO in 177 patients with elderly hypertension were tested，and patients were divided into the group Q1，the group Q2 and the group Q3 according to serum Hcy concentration. One-way ANOVA was used to analyze the difference of parameters among three groups. The correlation between Hcy and TNF-α，IL-6，ET and NO was analyzed by Pearson correlation coefficient. Binary Logistic regression was used to analyze the particular impact of Hcy on TNF-α，IL-6，ET and NO. Results：Hcy，TNF-α，IL-6 and ET in the group Q2 and group Q3 were significantly higher than those in the group Q1，while NO was significantly decreased（all P<0.05）. Pearson correlation analysis showed that Hcy was positively correlated with TNF-α，IL-6 and ET（r values were 0.676，0.852 and 0.730 respectively） and was negatively correlated with NO（r=-0.637），with statistically signif－icant difference（all P<0.05）. After correcting other factors，logistic regression analysis showed that Hcy was a risk factor for elevation of TNF-α，IL-6 and ET（all P<0.05），and was a protective factor for NO elevation（P<0.05）. Conclusion：Serum Hcy and TNF-α，IL-6，ET and NO in patients with elderly hypertension has correlation. The high Hcy may lead to immune inflammation damage and vascu－lar endothelial dysfunction，and then participate in the pathologic process of elderly hypertension.