高血压患者同型半胱氨酸与肾功能及凝血指标的相关性研究  

Correlation study of serum homocysteine with renal function and coagulation indexes in hypertensive patients

作　　者：邢艳粉 李永伟[1] Xing Yanfen;Li Yongwei(Department of Clinical Laboratory, the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450002, China)

机构地区：[1]河南中医药大学第二附属医院检验科,河南450002

出　　处：《中华检验医学杂志》2018年第12期952-958,共7页Chinese Journal of Laboratory Medicine

基　　金：国家高技术研究发展计划"863"计划 (2014AA022304).

摘　　要：目的探讨高血压患者中血清同型半胱氨酸(Hcy)与肾脏功能以及凝血系统相关性的研究。方法通过回顾性研究设计,选取2017年至2018年在河南省中医院就诊的高血压患者224例,健康体检者212名,其中高Hcy者218例、正常Hcy者218例。实验根据高血压及Hcy水平分为正常血压正常Hcy亚组103例、正常血压高Hcy亚组109例、高血压正常Hcy亚组115例以及高血压高Hcy亚组109例。采用全自动生化分析仪检测血清中Hcy、血脂、肾功能等生化指标,采用血凝仪检测血浆中凝血功能等各种指标,采用血细胞分析仪检测血小板(PLT)等指标。通过单因素方差分析比较4个亚组之间水平差异,并采用Pearson积差相关系数分析以及多因素Logistic回归分析等统计学方法分析其相关性及影响因素。结果血清Urea在高血压高Hcy亚组的水平(5.73±1.67)mmol/L高于正常血压正常Hcy亚组水平(4.79±1.05)mmol/L,两组有统计学差异(t=3.508, P=0.001),在高血压高Hcy亚组水平(5.73±1.67)mmol/L高于正常血压高Hcy亚组水平(5.21±1.21)mmol/L,两组相比Urea有明显升高趋势(t=1.983, P=0.049),Urea在高血压高Hcy亚组水平(5.73±1.67)mmol/L明显高于高血压正常Hcy亚组水平(4.81±1.21 )mmol/L(t=3.600, P=0.000);血清Crea在高血压高Hcy亚组水平(79.52±25.92)μmol/L高于正常血压正常Hcy亚组水平(58.39±12.83)μmol/L(t=6.121, P=0.000)及高血压正常Hcy亚组水平(60.93±13.74)μmol/L(t=5.526, P=0.000);血清UA在高血压高Hcy亚组水平(389.96±96.03)μmol/L显著高于正常血压正常Hcy亚组水平(293.65±89.94)μmol/L(t=5.722, P=0.000)、正常血压高Hcy亚组水平(327.02±66.55)μmol/L,(t=3.837, P=0.000)以及高血压正常Hcy亚组水平(291.50±73.42)μmol/L(t=6.128, P=0.000)。血清BMG及CysC在高血压高Hcy亚组和正常血压高Hcy亚组中水平明显高于正常血压正常Hcy亚组和高血压正常Hcy亚组水平。高血压高Hcy亚组中RBP、D-Dimer、FDP水平显著高于其余3个亚�Objective The purpose of this study was to investigate the correlation of serum homocysteine with renal function and coagulation indexes in hypertensive patients. Methods Through retrospective design, 224 hypertensive patients and 212 healthy subjects who sought medical service in Henan Province Hospital of TCM during 2017 to 2018, were divided into four groups according to hypertension and homocysteine level, that was normotensive normal Hcy group (103 patients), normotensive high Hcy group (109 patients), hypertensive normal Hcy group (115 patients), and hypertensive high Hcy group (109 patients). Serum homocysteine, serum lipid and renal function indexes were detected by automatic biochemical analyzer. The level of coagulation indexes were detected by automatic coagulation analyzer and platelet was tested by automatic blood cell analyzer. Comparisons of variables between four groups were evaluated by one way ANOVA. The correlation was expressed by the Pearson′s correlation coefficient analysis. Multivariate linear regression analysis was performed to identify variables and influence factor associated with Hcy. Results The concentration of Urea in hypertensive high Hcy group (5.73±1.67)mmol/L was significantly increased compared to normotensive normal Hcy group (4.79±1.05)mmol/L (t=3.508, P=0.001). The leve of Urea in hypertensive high Hcy group (5.73±1.67)mmol/L was significantly increased compared to normotensive high Hcy group (5.21±1.21)mmol/L (t=1.983, P=0.049) and hypertensive normal Hcy group (4.81±1.21)mmol/L (t=3.600, P=0.000). The level of Crea in hypertensive high Hcy group (79.52±25.92)μmol/L was significantly increased compared to normotensive normal Hcy group (58.39±12.83)μmol/L (t=6.121, P=0.000) and hypertensive normal Hcy group (60.93±13.74)μmol/L (t=5.526, P=0.000). The level of UA in hypertensive high Hcy group (389.96±96.03)μmol/L were significantly higher than normotensive normal Hcy group (293.65±89.94)μmol/L (t=5.722, P=0.000), normotensive high Hcy group (327.02±66.55)�

关 键 词：高血压 同型半胱氨酸 Β-微球蛋白 视黄醇结合蛋白 胱抑素C D-二聚体 纤维蛋白(原)降解产物 

分 类 号：R544.1[医药卫生—心血管疾病] R446.1[医药卫生—内科学]