中青年难治性高血压患者血清同型半胱氨酸与动脉僵硬度的关系  

The relationship between serum homocysteine and arterial stiffness in young patients with resistant hypertension

作　　者：杜天天[1] 郑成[2] 蔡情情[1] 庞敏[3] 张宇萌[4] 宫海滨[4,5] 

机构地区：[1]徐州医学院研究生学院,江苏徐州221009 [2]徐州市中心医院神经外科 [3]徐州市中心医院超声科 [4]徐州医学院徐州临床学院 [5]徐州市中心医院心内科

出　　处：《中华高血压杂志》2016年第6期547-551,共5页Chinese Journal of Hypertension

基　　金：江苏省临床医学科技专项(BL2012019)

摘　　要：目的观察中青年难治性高血压(RH)患者血清同型半胱氨酸水平与动脉僵硬度的关系。方法入选2014年5月至2016年2月于徐州市中心医院高血压门诊就诊的中青年RH患者62例,并入选血压控制达标的高血压(CH)患者84例和正常血压者67人,按血清同型半胱氨酸(Hcy)水平(<10和≥10μmol/L)进行分层分析。应用主动脉波形分析仪及内皮功能检测仪检测患者中心动脉压、颈股动脉脉搏波传导速度(cfPWV)、中心动脉增强指数(AIx)及内皮功能指数(RHI)。结果在RH患者中,高Hcy组cfPWV和RHI均高于正常Hcy组[(9.71±1.77)比(8.36±1.33)m/s,2.09±0.64比1.73±0.28;均P<0.05],两亚组的中心动脉压和AIx的差异无统计学意义(均P>0.05);而在CH患者及正常血压人群中,高Hcy组与正常Hcy组以上指标的差异无统计学意义(均P>0.05)。调整混杂因素后,RH患者中血清Hcy与cfPWV呈正相关(r=0.362,P=0.045)。多元线性回归分析显示,在RH患者中血清Hcy是cfPWV的独立危险因素(B=1.041,P=0.039)。结论在中青年RH患者中,血清Hcy升高可能与动脉僵硬度进展相关。Objective To investigate the relationship between serum homocysteine（Hcy）and arterial stiffness in young resistant hypertension（RH）patients. Methods Sixty-two resistant hypertensive（RH）patients,84 controlled hypertensive（CH）patients and 67normotensives（NH）at outpatient clinic in Xuzhou Central Hospital between May 2014 and February 2016 were recruited. Stratified analysis was performed according to the serum level of Hcy（〈10and ≥10μmol/L）. Central arterial blood pressure,carotid-femoral pulse wave velocity（cfPWV）,augmentation index（AIx）,and endothelial function index（RHI）were assessed by aortic waveform analyzer and endothelial function detector. Results In patients with RH,cfPWV and RHI in high Hcy group were higher than that in normal Hcy group [（9.71±1.77）vs（8.36±1.33）m/s,2.09±0.64 vs 1.73±0.28;both P〈0.05].There was no statistical significance in arterial pressure and AIx between two groups（both P〈0.05）. In patients with CH and NH,the differences of above indexes between subjects with high Hcy and normal Hcy had no statistical significance（all P〈0.05）. After adjusting for the confounding factors,serum Hcy was positively correlated with cfPWV in RH patients（r=0.362,P=0.045）. Multivariate linear regression analysis showed that serum Hcy was an independent risk factor for cfPWV in patients with RH（B=1.041,P=0.039）. Conclusion In young patients with RH,elevated serum Hcy correlates with the development of arterial stiffness.

关 键 词：难治性高血压 血清同型半胱氨酸 动脉僵硬度 脉搏波传导速度 

分 类 号：R544.1[医药卫生—心血管疾病]