血浆同型半胱氨酸水平对原发性高血压患者冠心病发生的相关性研究  

Correlation research of plasma homocysteine level for occurrence of coronary heart disease in patients with essential hypertension

作　　者：吴崇 孙莹 王嫘[2] 李廷富[2] 

机构地区：[1]辽宁电力中心医院综合内科,辽宁省沈阳市110002 [2]中国医科大学附属第一医院老年病房

出　　处：《中国心血管病研究》2015年第10期913-916,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨血浆同型半胱氨酸水平对原发性高血压患者发生冠心病的预测价值.方法 选择2010年1月至2012年1月我院接受冠状动脉造影检查的原发性高血压患者251例,根据冠脉造影情况分为单纯高血压组（120例）和高血压合并冠心病组（131例）.分析高血压患者血浆同型半胱氨酸水平,比较不同同型半胱氨酸水平患者冠心病的发病率,并通过Logistic回归分析原发性高血压患者发生冠心病的危险因素.结果 高血压合并冠心病组患者血浆同型半胱氨酸和低密度脂蛋白水平[（14.69±7.39） μmol/L,（3.14±0.22）mmol/L]高于单纯高血压组患者[（19.03±7.33）μmol/L,（3.37±0.34）mmol/L],而高密度脂蛋白水平[（1.31±0.38）mmol/L]低于单纯高血压组患者[（1.15±0.42）mmol/L],差异均有统计学意义（P=0.000,P=0.002,P=0.000）.血浆同型半胱氨酸水平（OR =4.503,P=0.021）和低密度脂蛋白水平（OR =3.509,P=0.000）是原发性高血压患者发生冠心病的独立危险因素.高密度脂蛋白可以降低原发性高血压患者发生冠心病的风险（OR =0.439,P=0.012）.结论 血浆同型半胱氨酸水平越高,原发性高血压患者发生冠心病的可能性越大.Objective To explore the value of homocysteine （Hey） in patients with essential hypertension to predict the occurrence of coronary heart disease （CHD）. Methods Based on the results of coronary angiography, 251 patients with essential hypertension were divided into two groups as essential hypertension group （n=121） and essential hypertension with CHD group （n=130）. Hcy level was analyzed in patients with essential hypertension and was used to evaluate the occurrence of CHD. The logistic regression model was used to analyze the risk factors for occurrence of CHD. Results The levels of Hey and low density lipoprotein-cholesterol [（14.69＋7.39）lxmol/L, （3.14±0.22）mmol/L] in essential hypertension with CHD group were higher than that in essential hypertension group [（19.03 ±7.33）μmol/L, （3.37 ±0.34）mmol/L], while high density lipoproteincholesterol [（1.31 ±0.38）mmol/L] was lower than essential hypertension group [（1.15±0.42）mmol/L]. In the logistic regression model, the levels of homocysteine（P=0.019） and low density lipoprotein-eholesterol（P=0.028 ） were the independent predictors for occurrence of CHD in patients with essential hypertension, while high density lipoprotein-eholesterol can lower the occurrence of CHD in patients with essential hypertension （P=0.020）. Conclusion The elevated level of Hey has the prognostic value for the occurrence of CHD in patients with essential hypertension.

关 键 词：高血压 冠状动脉疾病 同型半胱氨酸 

分 类 号：R544.1[医药卫生—心血管疾病]