高血压病患者血清胆红素和脂联素的变化和临床意义.docVIP

高血压病患者血清胆红素与脂联素的变化及意义 鲍行峰 浙江省宁波市鄞州人民医院门诊内科（邮编315040）摘要：目的： 探讨高血压病患者血清中胆红素与脂联素(APN)的变化及临床意义。方法：在我院就诊的高血压患者76例，检测血清中总胆红素、直接胆红素、间接胆红素与APN的水平，分析APN与胆红素与高血压之间的相关性。结果：与健康对照组相比，高血压病患者体重、BMI水平明显增高，APN、总胆红素、间接胆红素水平较正常对照组明显降低，差异均具有统计学意义，但直接胆红素在两组间无统计学差异。血清中APN、总胆红素水平具有随血压的增高而降低的趋势。相关性分析表明，APN与体重、BMI具有明显的负相关关系，与总胆红素、间接胆红素具有明显的正相关。结论：血清中胆红素与脂联素与高血压具有明显的相关性，随血压的增高有降低的趋势，对评估高血压患者危险性及指导临床治疗具有重要的临床意义。 Clinical Significance of Serum Bilirubin and Adiponectin in Hypertensive Patients Abstract: Objective: To investigate the serum bilirubin and adiponectin in patients with essential hypertension and its clinical significance. Methods: 76 hypertensive patients were investigated. Serum total bilirubin, direct bilirubin, indirect bilirubin and adiponectin levels were detected. The relationship among adiponectin and high blood pressure and bilirubin and hypertension were analyzed. Results: Compared with healthy control group, body weight, BMI levels were significantly increased in hypertensive patients. APN, total bilirubin, indirect bilirubin levels significantly lower than the normal control group. But the direct bilirubin had no significant difference between the two groups. Serum APN and total bilirubin level were higher with the lowered blood pressure trend. Correlation analysis showed that, APN has a significant negative correlation with weight and BMI, and has a significant positive correlation with total bilirubin, indirect bilirubin. Conclusion: The serum bilirubin and adiponectin and hypertension have a significant correlation. With blood pressure increase has a falling trend. Serum bilirubin and adiponectin are better to assess risk in patients with hypertension and guiding clinical treatment. 脂联素(APN)是一种主要由脂肪细胞分泌的内源性生物活性因子，通过脂肪细胞的旁分泌、白分泌作用参与人体复杂的代谢过程，参与疾病的发生、发展。脂联素与高血压密切相关，脂联素水平是原发性高血压的独立危险因素。胆红素是血红素经肝脏微粒体氧化酶分解形成的产物，根据其是否与血清清蛋白结合分成直接与间接胆红素。低浓度血清胆红素与增加高血压的危险性，并提出低浓度血清胆红素是高血压新的独立危险因子[1]。1 资料及方法 1.1 临床资料 2008年8月至2009年10月在我院心内科门诊及住院已确诊的原发性高血压患者76例。其中男46名，女30名，年龄56.27±6.67岁。按《2005年