H型高血压与颈动脉结构改变的相关性研究  

Study of correlation between H type hypertension and the structural changes of carotid artery

作　　者：叶艳艳[1] 刘燕娜[1] 代妮娜[1] 郭良云[1] 张诗渊[1] 李车英[1] 吴清华[2] 熊棉妣 

机构地区：[1]南昌大学第二附属医院超声科,330006 [2]南昌大学第二附属医院心内科,330006

出　　处：《中华超声影像学杂志》2013年第11期936-940,共5页Chinese Journal of Ultrasonography

基　　金：江西省自然科学基金资助项目（20132BAB205030）

摘　　要：目的探讨H型高血压患者颈动脉结构改变及血浆同型半胱氨酸（homocysteine，Hcy）水平与颈动脉粥样硬化的相关性。方法将295例原发性高血压患者依据血浆Hcy水平分为H型高血压组阳单纯型高血压组，对两组患者行颈动脉超声检查及血生化测定，分析两组间颈动脉超声参数及其与Hcy水平的相关性，并行颈动脉斑块形成危险因素分析。结果H型高血压组和单纯型高血压组间斑块检出率、单发斑块检出率及≥2个斑块检出率差异有统计学意义（P〈0．05），内中膜厚度（intimamediahickness，IMT）[（1．00±0．16）Into对（0．89±0．18）mm]、斑块积分[（4．90±3．77）mm对（1．88±2．28）nm]差异均有统计学意义（P〈0．05）。颈动脉IMT与Hcy呈正相关（n=0．371，P=0．000），斑块积分与Hcy呈正相关（r2=0．696，P=0．000）。Logistic回归显示年龄、IMT≥1．0mm及Hcy≥10．0μmol／L是颈动脉斑块形成的危险因素。结论H型高血压患者颈动脉结构损害更严重，表明高Hcy血症与高血玉具有协同作用，并且Hcy水平与颈动脉斑块形成及颈动脉硬化程度呈正相关，参与颈动脉粥样硬化的发畏过程。Objective To investigate the correlations of the structural change of carotid artery and the level of plasma homocysteine （Hcy） with the severity of carotid artery atherosclerosis in H type hypertension patients. Methods 295 essential hypertension patients were divided into two groups： H type hypertension group and simple hypertension group according to the concentration of plasma Hcy. All patients were underwent the carotid high-resolution ultrasonic examination and blood biochemical measurement to analyse the ultrasonic parameters and the correlation with the level of plasma Hcy, and to analyse the risk factors of carotid plaques formation. Results Comparison of H type hypertension group with simple hypertension group showed that：there were statistical differences between two groups in plaque detection rate,single plaque detection rate and ~2 plaques detection rate （ all P ~ 0.05）; there were statistical differences between two groups in intima-media thickness（IMT） with （1.00 ＋ 0.16）mm vs （0.89 ＋ 0.18）mm and in plaque score with （4.90 ＋ 3.77）ram vs （1.88 ＋ 2.28）mm （ all P d0.05）. There were positive correlations of the level of plasma homocysteine with the carotid IMT （rl = 0. 371, P = 0. 000） ,and with the carotid plaque score （r2 = 0. 696, P = 0. 000）. The age,IMT^l. 0 mm and Hcy~/0.0 gmol/L were risk factors of carotid atherosclerotic plaque formation by the binary Logistic regression analysis. Conclusions The more serious structural damage of carotid artery in H type hypertension compared with simple hypertension showed that there was a synergistic effect between the elevated plasma Hcy and hypertension, and there were positive correlations of the level of plasma Hcy with the plaque formation and the degree of carotid atherosclerosis, the level of plasma Hcy took part in the development process of carotid atherosclerosis.

关 键 词：超声检查 高血压 同型半胱氨酸 颈动脉 

分 类 号：R544.1[医药卫生—心血管疾病]