高同型半胱氨酸血症对老年原发性高血压患者动脉僵硬度的影响  

Effect of hyperhomocysteinemia on arterial stiffness in elderly essential hypertension patients

作　　者：白熙[1] 陈哲[1] 张辉[1] 刘淼冰[1] 孙倩美[1] 

机构地区：[1]首都医科大学附属北京朝阳医院综合科,100020

出　　处：《中华老年心脑血管病杂志》2017年第1期28-30,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：首都全科医学研究专项(16QK02);首都医科大学项目(14JL41)

摘　　要：目的探讨高同型半胱氨酸血症(HHcy)对老年原发性高血压患者动脉僵硬度的影响。方法选择老年原发性高血压患者66例(高血压组),其中HHcy 32例,非HHcy 34例。另外入选无高血压史老年健康体检者58例(对照组),其中HHcy 14例,非HHcy 44例。测定2组患者血脂、空腹血糖、空腹胰岛素及血同型半胱氨酸(Hcy)水平,计算稳态模型胰岛素抵抗指数。通过颈动脉-股动脉肢体动脉搏动波(cfPWV)评估动脉僵硬度。结果高血压组Hcy和cfPWV显著高于对照组[(15.48±6.38)μmol/L vs(12.96±4.01)μmol/L,P<0.05;(14.46±1.62)m/s vs(10.81±1.59)m/s,P<0.05]。所有受试者血浆Hcy与cfPWV呈正相关(r=0.529,95%CI:0.040~0.079,P<0.01)。高血压组HHcy患者胰岛素抵抗指数和cfPWV显著高于非HHcy患者[3.84±2.16 vs 2.58±1.56,P=0.018;(14.97±1.22)m/s vs(11.09±1.49)m/s,P=0.004]。结论伴有HHcy的老年原发性高血压患者动脉僵硬度增高,可能与促进胰岛素抵抗等机制有关。Objective To study the effect of hyperhomocysteinemia（HHcy）on arterial stiffness in elderly essential hypertension patients.Methods Sixty-six elderly essential hypertension patients served as a hypertension group and 58 elderly subjects without hypertension history served as a control group in this study.Their serum levels of blood lipid,fasting blood glucose,insulin,Hcy,and HOMA-IR index were measured and their arterial stiffness was assessed according to their cfPWV.Results The Hcy level and cfPWV were significantly higher in hypertension group than in control group（P〈0.05）.The Hcy level was positively related with the cfPWV（r=0.529,95%CI：0.040-0.079,P〈0.01）.The HOMA-IR index and cfPWV were significantly higher in hypertension group than in control group（P〈0.01）.Conclusion Elevated arterial stiffness is related with insulin resistance in elderly essential hypertension patients with HHcy.

关 键 词：高同种半胱氨酸血症 高血压 动脉硬化 胰岛素抗药性 

分 类 号：R544.11[医药卫生—心血管疾病] R543.5[医药卫生—内科学]