H型高血压伴冠心病患者CRP VCAM-1 NHR 脂代谢特点及与心功能不全的相关性

doi:10.3969/j.issn.1006-6233.2023.04.021

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Abstract Objective: To investigate the correlation between C-reactive protein (CRP), vascular endothelial adhesion molecule-1 (VCAM-1), neutrophil/HDL cholesterol ratio (NHR), lipid metabolism characteristics and with cardiac insufficiency in patients with H-type hypertension with coronary artery disease. Methods: 104 patients with hypertension complicated with coronary artery disease treated in our hospital from January 2020 to January 2022 were selected, including 49 patients with H-type hypertension complicated with coronary artery disease (observation group) and 55 patients with non-H-type hypertension complicated with coronary artery disease (control group), the serum CRP, VCAM-1, NHR, lipid metabolism indexes and cardiac function grades of the two groups were compared, and the differences in relevant indexes of patients with different cardiac functional grades were analyzed at the same time. Results: Compared with the control group, serum CRP, VCAM-1 and NHR of the observation group were higher [(5.15±1.03) mg/L, (780.05±81.16) ng/ml and (5.05±0.79) ng/ml)](P<0.05), while the high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (APOAI) were lower [(1.03 ± 0.24) mmol/l and (0.66±0.29) g/L](P<0.05). Compared with the control group, the NYHA grade III ~ IV ratio, left ventricular end diastolic diameter (LVDD), left atrial diameter (LAD) and Gensini score in the observation group were higher [61.22%, (4.66±0.40) cm, (4.66±0.40) cm, (4.01±0.39) cm and (52.26±13.35) points](P<0.05), while the left ventricular ejection fraction (LVEF) was lower [(52.64±5.16)%](P<0.05). The scores of CRP, VCAM-1, NHR and Gensini in patients with grade III ~ IV cardiac function in the observation group were (5.32±0.72) mg/L, (804.69 ± 69.50) ng/ml, (5.30±0.90) and (55.15±9.31) respectively, which were significantly higher than those in patients with grade I ~ II (P<0.05), while HDL-C and LVEF were (0.97±0.23) mmol/l and (51.52±4.60)% respectively, which were significantly lower than those in patients with grade I ~ II (P<0.05). NYHA grade was positively correlated with CRP, VCAM-1 and NHR (P<0.05), but negatively correlated with HDL-C (P<0.05). Gensini score was positively correlated with NHR (P<0.05), but negatively correlated with HDL-C (P<0.05). Conclusion: The levels of CRP, VCAM-1 and NHR in patients with H-type hypertension complicated with coronary artery disease increase, the three factors are positively correlated with cardiac function grade and coronary severity.

Key words： H-type hypertension Coronary heart disease C-reactive protein Vascular endothelial adhesion molecule-1 Neutrophil / high density lipoprotein cholesterol ratio Lipid metabolism Cardiac function classification

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.04.021 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I4/630

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