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目的探讨高血压和C反应蛋白(CRP)在颈动脉粥样斑块患病危险中的联合作用。方法2002年对北京大学社区866人进行心血管病危险因素调查和颈动脉超声检查;以颈动脉粥样斑块作为评价指标,以高血压和CRP水平升高作为研究因素。结果(1)血压水平分级和CRP四分位分层的偏相关系数为0.089(P=0.008);(2)男性颈动脉粥样斑块患病率随CRP四分位呈升高的趋势,CRP水平升高是颈动脉粥样斑块患病的独立影响因素(均为P<0.01);(3)与仅有高血压或CRP升高组相比,同时有高血压和CRP升高组的颈动脉粥样斑块患病率最高,达50.4%(P<0.01);(4)与无高血压和无CRP升高组相比,同时有高血压和CRP升高者患有颈动脉粥样斑块的危险上升了2.0倍(P<0.01);(5)高血压和CRP升高的交互作用有统计学意义,Exp(B)为1.792(95%CI:1.189～2.701)(P=0.005)。结论高血压和CRP升高在颈动脉粥样斑块患病中具有协同作用,在控制高血压的同时降低血管炎性,对预防动脉粥样斑块可能具有更大的保护作用。
Objective To investigate the combined effect of hypertension and C-reactive protein (CRP) on the risk of carotid plaque. Methods In 2002, we conducted a survey of cardiovascular risk factors and carotid ultrasonography in 866 people in Peking University. The carotid artery atherosclerotic plaque was used as the evaluation index, and hypertension and CRP levels were taken as the research factors. Results (1) The partial correlation coefficient of blood pressure level and CRP quartile was 0.089 (P = 0.008). (2) The prevalence of carotid atherosclerotic plaque in male was increased with the quartile of CRP, (3) Compared with only high blood pressure or high CRP group, there were both high blood pressure and CRP elevated group Of carotid artery atherosclerotic plaque was the highest, accounting for 50.4% (P <0.01). (4) Patients with both high blood pressure and elevated CRP had carotid atherosclerosis The risk of atherosclerotic plaque increased by 2.0-fold (P <0.01). (5) The interaction between hypertension and CRP was statistically significant, with an Exp (B) of 1.792 (95% CI 1.189-2.701) = 0.005). Conclusions Hypertension and elevated CRP play a synergistic role in the pathogenesis of carotid atherosclerotic plaque. It may reduce the vasculitis while controlling hypertension and may have a greater protective effect on prevention of atherosclerotic plaque.