[1]张艳格,安珍,姜静,等.大气细颗粒物2.5对中老年高血压患者急性心血管效应的影响[J].新乡医学院学报,2023,40(2):119-124.[doi:10.7683/xxyxyxb.2023.02.004]
　ZHANG Yange,AN Zhen,JIANG Jing,et al.Effect of atmospheric particulate matter 2.5 on acute cardiovascular effect in middle-aged and elderly patients with hypertension[J].Journal of Xinxiang Medical University,2023,40(2):119-124.[doi:10.7683/xxyxyxb.2023.02.004]
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大气细颗粒物2.5对中老年高血压患者急性心血管效应的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年2期
页码:
119-124
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Effect of atmospheric particulate matter 2.5 on acute cardiovascular effect in middle-aged and elderly patients with hypertension
作者:
张艳格; 安珍; 姜静; 孙贝贝; 宋杰; 李娟; 王贵; 王亚; 吴卫东
（新乡医学院公共卫生学院，河南　新乡　453003）
Author(s):
ZHANG Yan′ge; AN Zhen; JIANG Jing; SUN Beibei; SONG Jie; LI Juan; WANG Gui; WANG Ya; WU Weidong
(School of Public Health,Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
细颗粒物2.5; 定组研究; 高血压; 心血管效应
Keywords:
particulate matter 2.5; panel study; hypertension; cardiovascular effect
分类号:
R544.1
DOI:
10.7683/xxyxyxb.2023.02.004
文献标志码:
A
摘要:
目的　探讨新乡地区大气细颗粒物2.5（PM2.5）暴露对中老年高血压患者心血管效应的影响。
方法　招募新乡医学院11例患高血压病的退休职工为研究对象，采用定组研究方法，从2018年12月至2019年4月进行5次随访，每次随访时间间隔4周，随访当日测量患者的血压、身高、体质量和静态心电图，记录心率（HR）值；采集患者空腹外周静脉血，采用酶联免疫吸附测定法测定患者血清炎症标志物白细胞介素（IL）-6、IL-8、超敏C-反应蛋白（hs-CRP）及氧化应激标志物8-羟基脱氧鸟苷（8-OHdG）、纤溶功能标志物组织型纤溶酶原激活剂（t-PA）、血浆内皮功能指标内皮素-1（ET-1）水平，并检测血小板-单核细胞聚合体（PMAs）数量，计算PMAs占单核细胞的百分比。收集每次体检前1周内患者居住区的每小时空气污染物PM2.5浓度和气温、相对湿度数据。采用线性混合效应模型评估大气PM2.5浓度与受试者血压、炎症标志物、氧化应激标志物、内皮功能指标及凝血标志物等的关系。
结果　大气PM2.5浓度每升高10 μg·m-3，患者的HR升高26.85 次·min-1［95%置信区间（CI）：1.83～51.88］，舒张压升高44.90 mm Hg（95%CI：3.18～86.61），血清IL-8、hs-CRP、8-OHdG水平分别升高26.56%（95%CI：0.76%～52.35%）、84.69%（95%CI：18.32%～151.05%）、68.94%（95%CI：35.77%～102.11%），血浆ET-1水平升高29.01%（95%CI： 6.72%～51.30%），PMAs水平升高8.19%（95%CI：2.05%～14.32%），t-PA水平下降408.85%（95%CI：-720.75%～-96.94%），差异有统计学意义（P<0.05）。
结论　PM2.5暴露可诱发中老年高血压患者出现血压异常、炎症反应、氧化应激、血管内皮损伤和凝血功能障碍等改变。
Abstract:
Objective　To investigate the effect of atmospheric particulate matter 2.5(PM2.5) exposure on cardiovascular effect in middle-aged and elderly patients with hypertension in Xinxiang area.
Methods　A total of 11 retired employees suffering from hypertension in Xinxiang Medical University were recruited as the research objects,and a group study method was adopted,the patients were followed up for 5 times from December 2018 to April 2019,with an interval of 4 weeks.On the day of follow-up,the blood pressure,height,body mass and static electrocardiogram,heart rate (HR) of the patients was recorded;the fasting peripheral venous blood of the patients was collected,and the levels of serum inflammatory markers interleukin(IL)-6,IL-8,hypersensitive C-reactive protein (hs-CRP),and oxidative stress marker 8-hydroxy-2′-deoxyguanosine (8-OHdG),fibrinolytic function marker tissue type plasminogen activator (t-PA) and plasma endothelial function indicator endothelin-1 (ET-1) were measured by enzyme-linked immunosorbent assay;the amount of platelet-monocyte aggregates (PMAs) was detected and the percentage of PMAs in monocytes was calculated.The hourly air pollutant PM2.5 concentration,temperature and relative humidity data in the residential area of the patients within one week before each physical examination were collected.The relationships between atmospheric PM2.5 concentration and blood pressure,inflammatory markers,oxidative stress markers,endothelial function indicator and blood coagulation markers were evaluated by Linear mixed effect model.
Results　For atmospheric PM2.5 concentration every increasing of 10 μg·m-3,the HR of the subjects increased by 26.85 times·min-1 ［95% confidence interval (CI):1.83-51.88］,diastolic pressure increased by 44.90 mm Hg (95%CI:3.18-86.61),and serum IL-8,hs-CRP,8-OHdG levels increased by 26.56%(95%CI:0.76%-52.35%),84.69%(95%CI:18.32%-151.05%),68.94%(95%CI:35.77%-102.11%),respectively;the plasma ET-1 level increased by 29.01%(95%CI:6.72%-51.30%),the PMAs level increased by 8.19%(95%CI:2.05%-14.32%),and the t-PA level decreased by 408.85% (95%CI:-720.75%--96.94%),there was statistically significant differences(P<0.05).
Conclusion　PM2.5 exposure can induce abnormal blood pressure,inflammatory response,oxidative stress,vascular endothelial damage and coagulation dysfunction in middle-aged and elderly patients with hypertension.

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更新日期/Last Update: 2023-02-05