原发性高血压患者血浆纤维蛋白原水平与血流介导的血管舒张功能的关系

The correlation between plasma fibrinogen levels and blood flow-mediated dilation function in essential hypertension patients

    摘要
  • 摘要:
    目的 探讨原发性高血压（EH）患者血浆纤维蛋白原（Fib）水平与血流介导的血管舒张功能（FMD）的关系。
    方法 回顾性分析就诊于福建医科大学附属第一医院老年医学科门诊的EH患者890例，以FMD≥ 6%为切点，按FMD结果分为FMD正常组（n = 680）与FMD异常组（n = 210），比较两组的基线资料和Fib水平。采用单因素和多因素线性回归模型分析EH患者中Fib与 FMD的相关性。根据性别、年龄、是否合并2型糖尿病（T2DM）、血脂异常、肥胖将EH患者分为不同亚组，运用多因素线性回归模型分析各个亚组中Fib与 FMD的相关性。
    结果 FMD异常组Fib水平高于FMD正常组（3.47±0.92）比（3.11±0.89）g/L，t = 1.25，P＜0.01，在EH患者中，单因素线性回归分析结果显示，FMD与Fib（B= –0.012，P＜0.001）呈负相关，多元线性回归分析，结果显示，校正年龄、体重指数、收缩压、空腹血糖、甘油三酯后，Fib是EH患者FMD的独立影响因子（B= –0.007，P = 0.001）。亚组分析发现，经校正年龄、体重指数、收缩压、空腹血糖、甘油三酯后，除合并T2DM亚组之外，Fib是其余各亚组EH患者FMD的影响因素（均P＜0.05）。叠加分组分析发现，Fib是老年男性（B= −0.007，P=0.020）、老年女性（B=−0.009，P=0.022）EH患者FMD的独立影响因素。
    结论 EH患者中，FMD异常者的Fib水平升高；除合并糖尿病的亚组外，其他亚组Fib均与 FMD 相关。

     

    Abstract:
    Objective To investigate the relationship between plasma fibrinogen (Fib) level and flow-mediated dilation (FMD) in essential hypertension (EH) patients.
    Methods A retrospective analysis was conducted on 890 patients with EH patients who attended the geriatrics outpatient clinic at the First Affiliated Hospital of Fujian Medical University. Using a cutoff value of FMD ≥ 6%, the patients were divided into a normal FMD group (n = 680) and an abnormal FMD group (n = 210). Baseline characteristics and Fib levels were compared between the two groups. Univariate and multivariate linear regression models were used to analyze the correlation between Fib and FMD in EH patients. The EH patients were further stratified into subgroups according to gender, age, and the presence of type 2 diabetes mellitus (T2DM), dyslipidemia, and obesity. Multivariate linear regression was applied to examine the association between Fib and FMD in each subgroup.
    Results The Fib level in the abnormal FMD group was higher than that in the normal FMD group ( 3.47±0.92 vs 3.11±0.89 g/L, t = 1.25, P＜0.01). In EH patients, univariate linear regression showed that FMD was significantly negatively correlated with Fib (B= –0.012, P＜0.001). After adjusting for age, body mass index, systolic blood pressure, fasting blood glucose, and triglycerides,Multivariate linear regression revealed that Fib was an independent determinant of FMD in patients with EH (B= –0.007, P = 0.001). Subgroup analysis showed that after adjustment for age, body mass index, systolic blood pressure, fasting blood glucose, and triglycerides, Fib was associated with FMD in all EH subgroups except the T2DM-complicated subgroup (all P＜0.05). Further stratified analysis demonstrated that Fib was an independent determinant of FMD in elderly male EH patients (B= –0.007, P = 0.020) and elderly female EH patients (B= –0.009, P = 0.022).
    Conclusion  Among patients with EH, those with abnormal FMD also exhibited significantly elevated Fib levels. In addition to the subgroup with diabetes mellitus, Fib and age were independent predictors of FMD in EH, and BMI also had significant influence on FMD in some subgroups.In EH patients, Fib levels were elevated in those with abnormal FMD. Fib was associated with FMD in all subgroups except the subgroup complicated with diabetes mellitus.

     

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