高血压合并脑梗死患者同型半胱氨酸与颈动脉硬化相关性研究  

Relationship analysis between homocysteine and carotid artery atherosclerosis in acute cerebral infarction patients with hypertension

作　　者：王蕾[1] 陈哲萌[1] 陈浩[1] 杨柳[1] 黄菊明[1] 徐建红[1] 

机构地区：[1]浙江省嘉兴市第一医院神经内科,314000

出　　处：《中华全科医学》2015年第8期1270-1272,共3页Chinese Journal of General Practice

摘　　要：目的研究高血压合并急性脑梗死患者同型半胱氨酸(Hcy)与炎症因子、颈动脉粥样硬化及斑块形成的相关性。方法选取2013年7月1日—2014年6月30日在嘉兴市第一医院神经内科住院的原发性高血压合并急性脑梗死患者312例。于入院第2天早晨空腹抽取所有受试者的静脉血,根据Hcy水平分为实验组228例(Hcy>15μmol/L)和对照组84例(Hcy≤15μmol/L)。记录患者的年龄、性别、吸烟史、糖尿病、高脂血症等危险因素。比较2组患者临床资料、血脂、超敏C-反应蛋白(hs-CRP)、纤维蛋白原、D-二聚体水平、颈动脉内膜中层厚度(IMT)及不稳定斑块检出率。所收集的数据均采用SPSS 19.0统计分析软件进行分析。结果 H型高血压组与单纯高血压组在年龄、性别构成比、吸烟史、糖尿病史、血脂水平、纤维蛋白原、D-二聚体水平差异无统计学意义(P>0.05)。实验组CRP水平(5.60±2.37)mg/L、颈动脉不稳定斑块发生率57.9%、IMT(1.27±0.12)mm,对照组CRP水平(3.39±1.04)mg/L、颈动脉不稳定斑块发生率44.1%、IMT(1.13±0.10)mm,2组差异有统计学意义(P<0.05)。实验组Hcy水平与IMT呈正相关(r=0.25,P<0.05);对照组Hcy水平与IMT相关性无统计学意义(r=0.18,P>0.05)。结论高Hcy与高血压合并脑梗死患者的颈动脉粥样硬化发生发展密切相关。Objective To investigate the correlation between homocysteine and inflammatory mediator,carotid artery atherosclerosis and plaque in acute cerebral infarction patients with hypertension. Methods Selected the hospitalized patients of primary hypertension with acute cerebral infarction from July 1,2013 to June 30,2014 in department of neurology of the first hospital of Jiaxing city as the research object,all of which met the inclusion criteria. The fasting venous samples of all the subjects were collected at day 2 after the admission. In according to the level of homocysteine（ Hcy） divided into experimental group（ Hcy 15 μmol / L,n = 228） and control group（ Hcy≤15 μmol / L,n = 84）. The age,sex,smoking,diabetes,hyperlipidemia and other risk factors of the patients were documented. Compared two groups patients in clinical data,blood lipid,highly sensitive C-reactive protein（ hs-CRP）,fibrinogen,D-dimer level,unstable plaque detection rate and carotid artery intima-media thickness（ IMT）. All calculations were performed using SPSS 19. 0 software. Results There was no significant difference（ P 〉0. 05） in age,sex ratio,smoking history,diabetes history,blood lipid level and fibrinogen D dimer level between the two groups. hs-CRP,unstable carotid artery plaque detection rate and IMT in experimental group were significantly higher than those in control group. Regression analysis showed the Hcy level had positive relationship with IMT in experimental group（ r = 0. 25,P 〈0. 05） while no correlation in control group（ r = 0. 18,P 〈0. 05）.Conclusion High homocysteine type hypertension was an important risk factor of carotid artery atherosclerosis in acute cerebral infarction patients with hypertension.

关 键 词：高血压 颈动脉硬化 同型半胱氨酸 脑梗死 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]