H型高血压合并2型糖尿病患者血浆Hcy、Cyst-C水平与颈动脉内膜中层厚度的关系  

The correlation between the levels of plasma Hcy and Cyst-C,and carotid intima-media thickness in patients with H-hypertension complicated with type 2 diabetes

作　　者：莫新玲[1] 杨锡恒[1] 谢婷[1] 张锦华[1] 

机构地区：[1]桂林医学院附属医院心血管内科,广西桂林541001

出　　处：《广东医学》2017年第6期855-858,共4页Guangdong Medical Journal

基　　金：国家十二五"重大新药创制"科技重大专项(编号:2012ZX09101105);桂林市科学研究与技术开发计划项目(编号:20140120-1-5;20150206-1-7);广西高校科学技术研究项目(编号:KY2015LX265)

摘　　要：目的观察H型高血压合并2型糖尿病患者血浆同型半胱氨酸(Hcy)、胱抑素C(Cyst-C)水平与颈动脉内膜中层厚度(cIMT)的关系。方法收集符合入选标准的H型高血压合并2型糖尿病患者120例,应用彩色多普勒超声检查仪测定cIMT,根据颈动脉粥样硬化的程度分为3组,cIMT正常(cIMT<0.9 mm)组、cIMT增厚(0.9 mm≤cIMT<1.3 mm)组和颈动脉斑块(cIMT≥1.3 mm)组;按血压水平分为高血压1级(140~159/90~99mmHg)组、高血压2级(160~179/100~109 mmHg)组、高血压3级(≥180/110 mmHg)组,检测并比较3组间患者血糖、血脂、尿素氮、血肌酐、糖化血红蛋白(HbA_(1C))、血清Hcy、Cyst-C水平,分析血清Hcy、Cyst-C与颈动脉cIMT的关系。结果 (1)按cIMT分为3组,3组间血糖、血脂、尿素氮、血肌酐等比较差异无统计学意义(P>0.05),血清Hcy、Cyst-C比较差异有统计学意义(P<0.05),其水平随着cIMT增厚而增加;(2)按血压水平分为3组,高血压3级组血清Hcy、Cyst-C水平高于高血压1级、2级组,高血压2级组血清Hcy、Cyst-C水平高于高血压1级组(均P<0.05),其水平随着血压水平升高而升高;(3)cIMT与Hcy、Cyst-C、HbA_(1C)、收缩压、舒张压呈正相关(r=0.256、0.358、0.280、0.580、0.306,均P<0.05),进一步行二分类logistic回归分析显示Hcy、Cyst-C、HbA_(1C)、收缩压是cIMT增厚的独立危险因素(OR=55.257、1.545、3.121、1.154,均P<0.05)。结论 H型高血压合并2型糖尿病患者血清Hcy、Cyst-C水平与颈动脉粥样硬化具有密切相关性,是cIMT增厚的独立危险因素。Objective To investigate the correlation between the levels of plasma homocysteine （Hcy） and Cyst - C, and carotid intima - media thickness in patients with H - hypertension complicated with type 2 diabetes. Methods A total of 120 patients with H - hypertension complicated with type 2 diabetes. The application of color Doppler ultrasography was applied for the assessment of carotid intima - media thickness （cIMT）. According to the degree of carotid atheroscle- rosis, the subjects were divided into 3 groups, normal carotid IMT group （cIMT 〈 0. 9 mm）, carotid IMT thickening group （0. 9 mm ≤ cIMT 〈 1.3 ram） and carotid artery plaque group （ cIMT ≥ 1.3 mm）. According to the level of blood pressure, the subjects were divided into high blood pressure Level - 1 （140 - 159/90 -99 mmHg）, high blood pressure Level -2 （160 -179/100 -109 mmHg）, and high blood pressure Level-3 （over 180/110 mmHg）. The blood sugar, blood fat, blood urea nitrogen, creatinine, serum Hcy, and serum Cyst - C levels were assessed and analyzed. The correlation be- tween serum Hcy, Cyst - C and cIMT was analyzed. Results （ 1 ） according to the thickness of the carotid artery was di- vided into normal group, the thickening of the group, plaque formation, There was no significant difference in blood sugar, blood fat, urea nitrogen or serum creatinine among the 3 clMT groups （P 〉 0. 05）, though there were significant differences in serum Hcy and Cyst - C among them （P 〈 0. 05）. （2） The serum Hcy and Cyst - C in high blood pressure Level - 3 group was significantly higher than those of Level - 1 and Level - 2 groups ; and they were also significantly higher in Level - 2 group than Level - 1 group （ all P 〈 0. 05）. （3） The cIMT was significantly positively correlated with and Hcy, Cyst - C, HbAlc, systolic pressure and diastolic blood pressure （ P 〈 0.05 ）. And Hcy, Cyst - C, HbA,c, and systolic blood pres- sure were the independent risk factors for the development of clMT （P �

关 键 词：H型高血压 糖尿病 同型半胱氨酸 胱抑素C 颈动脉内膜中层厚度 

分 类 号：R544.1[医药卫生—心血管疾病]