老年原发性高血压患者内皮祖细胞与动脉硬化的关系^*

The relationship between endothelial progenitor cells and arteriosclerosis in elderly patients with essential hypertension

摘要

目的 探讨老年原发性高血压患者外周血内皮祖细胞(EPCs)与动脉硬化的相关性。方法 选取2024年7月—2025年7月就诊于内蒙古自治区人民医院健康管理中心及老年医学科的60岁及以上确诊为原发性高血压的老年患者340例作为研究对象,按EPCs水平四分位数将患者分为Q1组~Q4组,分别为85、85、83、87例;采用多因素线性回归模型探讨不同因素与动脉硬化的线性关系,依据是否有吸烟史、饮酒史、糖尿病史及体质量指数(BMI)水平(BMI≥28 kg/m²或BMI＜28 kg/m²)进行亚组分层以验证该关联的稳健性,同时绘制ROC曲线评估EPCs对老年原发性高血压患者发生动脉硬化的预测价值。结果 老年原发性高血压患者中,不同水平EPCs的人群年龄、性别、吸烟史、饮酒史、糖尿病史、收缩压(SBP)、舒张压(DBP)、臂踝脉搏波传导速度(baPWV)、心率(HR)、平均动脉压(MAP)、超敏C反应蛋白(hs-CRP)、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FBS)之间差异均具有统计学意义(P＜0.05)。多因素线性回归分析显示,糖尿病史、SBP为影响老年原发性高血压患者动脉硬化程度的独立危险因素,EPCs为其保护因素。亚组分析表明,EPCs与baPWV呈负相关(P＜0.05)。EPCs预测老年原发性高血压患者发生动脉硬化的ROC曲线下面积为0.883,相较于SBP显示出较高的预测价值。结论 外周血循环CD34⁺ CD309⁺双阳性EPCs与baPWV呈负相关,可以作为预测老年原发性高血压患者动脉硬化的一个生物学指标。

Abstract

Objective To investigate the correlation between peripheral blood endothelial progenitor cells (EPCs) and arteriosclerosis in elderly patients with essential hypertension. Methods A total of 340 elderly patients aged 60 years and above diagnosed with essential hypertension, who visited the Health Management Center and Department of Geriatrics at Inner Mongolia Autonomous Region People's Hospital from July 2024 to July 2025, were enrolled as study subjects.Patients were stratified into four groups (Q1-Q4) based on EPCs quartile levels, comprising 85, 85, 83, and 87 cases, respectively; multivariable linear regression models were constructed to investigate the linear relationships between various factors and arteriosclerosis/arterial stiffness. The robustness of the association was further assessed through subgroup analyses stratified by history of smoking, alcohol consumption, diabetes, and body mass index (BMI) levels (BMI ≥28 kg/m² vs. <28 kg/m²). Meanwhile, receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of EPCs for arteriosclerosis in elderly patients with essential hypertension. Results Among elderly patients with essential hypertension, there were statistically significant differences (P<0.05) in age, gender, smoking history, drinking history, diabetes history, systolic blood pressure (SBP), diastolic blood pressure (DBP), brachial-ankle pulse wave velocity (baPWV), heart rate (HR), mean arterial pressure (MAP), high-sensitivity C-reactive protein (hs-CRP), triglycerides (TG), total cholesterol (TC), and fasting blood glucose (FBG) across groups with different levels of endothelial progenitor cells (EPCs).Multivariate linear regression analysis showed that history of diabetes and SBP were independent risk factors for the degree of arteriosclerosis in elderly patients with essential hypertension, while EPCs were a protective factor. Subgroup analysis indicated that EPCs were negatively correlated with baPWV (P<0.05). The area under the ROC curve for EPCs in predicting arteriosclerosis in elderly patients with essential hypertension was 0.883, demonstrating a higher predictive value compared to SBP. Conclusion Circulating CD34⁺CD309⁺ double-positive EPCs in peripheral blood are negatively correlated with baPWV and may serve as a potential biomarker for predicting arterial stiffness in elderly patients with essential hypertension.

关键词

原发性高血压 / 内皮祖细胞 / 动脉硬化 / 臂踝脉搏波传导速度

Key words

Essential hypertension / Endothelial progenitor cells / Arteriosclerosis / Brachial-ankle pulse wave velocity

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基金资助

^*国家自然科学基金资助项目(82360285)