H型高血压患者血浆同型半胱氨酸、硫化氢水平与脑循环动力学的相关性  

Correlations between levels of plasma homocysteine and hydrogen sulfide and cerebral circulation dynamics in H type hypertension patients

作　　者：赵乾[1] 刘蕊[2] 徐振兴[1] 朱世明[1] 

机构地区：[1]山东大学附属济南市中心医院心内科,济南250063 [2]济南长虹医院,济南250011

出　　处：《山东大学学报（医学版）》2013年第2期57-60,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨H型高血压患者血浆同型半胱氨酸(Hcy)、硫化氢(H2S)水平与脑循环动力学的相关性。方法实验组104例高血压患者根据血浆Hcy水平分为H型高血压组(n=59例)和高血压组(n=45例),正常对照组32例。采用特定蛋白仪及硫敏感电极检测血浆Hcy和H2S水平;采用脑循环动力学检测仪检测脑血管血流动力学参数;采用全自动免疫分析仪检测血浆叶酸及维生素B12水平。结果与正常对照组和高血压组比较,H型高血压组患者血浆H2S、叶酸及维生素B12水平显著降低(P<0.05)。实验组患者脑循环动力学参数显著异常(P<0.001)。相关分析显示,H型高血压组血浆Hcy水平与H2S、叶酸及维生素B12水平呈负相关性(P<0.05);与颈动脉平均血流速度(Vmean)及颈动脉平均血流量(Qmean)呈负相关性(P<0.05);与脑血管外周阻力(Rv)、脑血管特性阻抗(Zc)及动态阻力(DR)呈正相关性(P<0.05)。实验组血浆H2S水平与Qmean呈正相关性(P<0.05),与Rv呈负相关性(P<0.05)。多元线性回归分析显示,Qmean与血浆Hcy水平具有数量依存关系,血浆Hcy升高是脑循环血流量减低的独立影响因素;Rv与血浆H2S水平具有数量依存关系,血浆H2S水平降低是脑血管阻力增加独立影响因素。结论 H型高血压患者血浆Hcy、H2S水平变化可影响脑血管生理功能并引起脑血流动力学的异常。Objective To investigate the correlations between plasma homocysteine （Hcy） and hydrogen sulfide （H2S） levels and parameters of cerebral circulation dynamics in H type hypertension patients. Methods 104 patients were graded in H type hypertension group and hypertension group according to the level of plasma Hcy with 32 normal controls as the control group. The levels of plasma Hcy and H2 S were measured by specific protein instrument and sulfur sensitive electrode. The parameters of cerebral circulation dynamics were detected by cerebral circulation dynamics detector. The levels of plasma folic acid and vitamin B2 were measured by auto DELFIA analyzer. Results Compared with those of the controls and the hypertension group, the levels of plasma H2S, folic acid and vitamin B12 significant decreased in the H type hypertension group（ P 〈 0.05 ）, and the parameters of cerebral circulation dynamics had significant differences in the experiment group（P 〈0.001 ）. The level of plasma Hcy in the H type hypertension group hadsignificantly nagative correlations with H2S, folic acid, vitamin Bag, Vmean and Qmean （P 〈 0.05）. But it had significantly positive correlations with Rv, Zc and DR （ P 〈 0.05 ）. The level of plasma Hz S in the experimental group had significantly positive correlations with Qmean （ P 〈 0.05 ） and nagative correlations with Rv （ P 〈 0.05 ）. Multiple linear regression analysis revealed a significant and independent association of Qmean with the increasing level of plasma Hcy, as was the association of Rv with the decreasing level of plasma H2 S. The increasing level of plasma Hcy was an independent risk factor for the decreasing cerebral blood flow, and the decreasing level of plasma H2S was an independent risk factor for the increasing cerebral vascular resistance. Conclusion Brain vascular physiology function was af- fected by the levels of plasma Hcy and H2S, which can cause changes of brain hemodynamics in H type hypertension.

关 键 词：同型半胱氨酸 硫化氢 脑循环动力学 H型高血压 

分 类 号：R544.1[医药卫生—心血管疾病]