同型半胱氨酸、血脂、肾功能指标及颈动脉超声在H型高血压中的临床应用价值  

Homocysteine,blood lipid,renal function and carotid ultrasound in H-type hypertension

作　　者：王蕾[1] 熊声贺[2] 张俊[3] 陈伟琴[3] 邓兵[3] 张一凡 

机构地区：[1]上海市第八人民医院检验科,上海200030 [2]南昌大学第三附属医院,江西南昌330077 [3]上海中医药大学附属龙华医院检验科,上海200032

出　　处：《检验医学》2017年第12期1109-1113,共5页Laboratory Medicine

基　　金：吴阶平医学基金会临床科研专项基金资助项目(320.6750.14190)

摘　　要：目的评估同型半胱氨酸(Hcy)、血脂、肾功能指标及颈动脉超声在H型高血压诊治中的临床应用价值。方法检测346例高血压患者和50名体检健康者(正常对照组)血压、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(apo)A1、apo B100、apo E、脂蛋白(a)[Lp(a)]、游离脂肪酸(FFA)、尿素、肌酐(Cr)、尿酸(UA)、胱抑素C(Cys C)水平并行颈动脉超声检查。将高血压患者根据Hcy水平分为H型高血压组(Hcy≥10μmol/L,168例)和非H型高血压组(Hcy<10μmol/L,178例)。结果 H型高血压组、非H型高血压组Hcy、TG、apo B100、Lp(a)、UA、Cys C水平均明显高于正常对照组(P<0.01),而apo A1水平低于正常对照组(P<0.01);H型高血压组Cr、尿素水平明显高于正常对照组(P<0.01),而apo A1水平明显低于非H型高血压组(P<0.01);H型高血压组年龄、男性比例、Hcy、apo B100、FFA、Cr、UA、尿素、Cys C水平明显高于非H型高血压组(P<0.01);其他指标3组之间差异均无统计学意义(P>0.05)。在H型高血压组中,Hcy与HDL-C、apo A1呈负相关(r值分别为-0.127、-0.214,P<0.05),与尿素、Cr、UA、Cys C均呈正相关(r值分别为0.337、0.446、0.240、0.438,P<0.05)。H型高血压组Hcy与颈动脉超声分组及血压分级呈正相关(r值均为0.383,P<0.05)。结论 H型高血压患者发生肾功能损伤及动脉粥样硬化风险更高,定期监测高血压患者的Hcy水平对于H型高血压的诊断、治疗及改善预后具有重要意义。Objective To evaluate the roles of homocysteine（Hcy）,blood lipid,renal function and carotid ultrasound in the diagnosis and treatment of H-type hypertension. Methods Atotal of 346 patients with hypertension and 50 healthy subjects（healthy control group） were enrolled. The levels of blood pressure,total cholesterol （TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol （LDL-C）,apolipoprotein（apo） A1,apo B100,apo E,lipoprotein（a）[Lp（a）],free fatty acid（FFA）, urea,creatinine（Cr）,uric acid（UA） and cystatin C（Cys C） were determined,and carotid ultrasound was performed. According to Hcy levels,the patients were classified into H-type hypertension group（Hcy≥10μmol/L, 168 cases） and non-H-type hypertension group（Hcy＆lt;10μmol/L,178 cases）.Results Compared with healthy control group,the levels of Hcy,TG,apo B100,Lp（a）,UA and Cys C were higher in hypertension group （P〈0.01）,while the level of apo A1 was lower（P〈0.01）. The levels of Cr and urea in H-type hypertension group were higher than those in healthy control group（P〈0.01）. Compared with non-H-type hypertension group,the levels of age,male proportion,Hcy,apo B100,FFA,Cr,UA,urea and Cys C were higher in H-type hypertension group（P〈0.01）,and the level of apo A1 was lower（P〈0.01）. There was no statistical significance for the other parameters among the 3 groups（P＆gt;0.05）. In H-type hypertension group,the level of Hcy was negatively correlated with the levels of HDL-C and apo A1（r=-0.127 and-0.214,P〈0.05）,and it was positively correlated with urea,Cr,UA and Cys C（r=0.337,0.446,0.240 and 0.438,P〈0.05）. Hcy level was positively correlated with carotid ultrasound grading and blood pressure classification in H-type hypertension group（r=0.383,P〈0.05）. Conclusions H-type hypertension patients have a high risk of renal function impairment and atherosclerosis,and the periodic monitoring of Hcy levels is importan

关 键 词：同型半胱氨酸 H型高血压 血脂 肾功能 颈动脉超声 

分 类 号：R446.1[医药卫生—诊断学]