H型高血压合并颈动脉粥样硬化患者血清Hcy含量与炎症因子、斑块稳定性的相关性  

Correlations of homocysteine with inflammatory factors and plaque stability in H-type hypertension patients combined with carotid atherosclerosis

作　　者：许金鹏[1] 刘洋 李靖[1] 邸卫英[3] 徐占稳[1] 赵兴洲[1] 宋书江[1] 刘福林[4] Jin-peng Xu;Yang Liu;Jing Li;Wei-ying Di;Zhan-wen Xu;Xing-zhou Zhao;Shu-jiang Song;Fu-lin Liu(Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China;Department of Cardiac Surgery, the No. 2. Hospital of Baoding, Baoding, Hebei 071051, China;Department of Neurology,Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China;Department of Cardiac Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China)

机构地区：[1]河北大学附属医院心内科,河北保定071000 [2]河北省保定市第二医院心外科,河北保定071051 [3]河北大学附属医院神经内科,河北保定071000 [4]河北大学附属医院心外科,河北保定071000

出　　处：《中国现代医学杂志》2017年第28期61-65,共5页China Journal of Modern Medicine

摘　　要：目的观察H型高血压合并颈动脉粥样硬化患者血清同型半胱氨酸(Hcy)含量变化,探讨Hcy与炎症因子、斑块稳定性的关系。方法选取2014年5月-2016年5月在该院接受住院治疗的高血压合并颈动脉粥样硬化患者患者90例。根据其血清Hcy含量分为普通高血压合并颈动脉粥样硬化组(普通高血压组,Hcy<10μmol/L,n=47)、H型高血压合并颈动脉粥样硬化组(H型高血压组,Hcy≥10μmol/L,n=43),选取同期在该院接受体检的健康人群作为对照组(n=58)。检测各组研究对象的血清Hcy、炎症因子及斑块稳定性指标含量,进一步分析Hcy含量与炎症因子、斑块稳定性的相关性。结果普通高血压组及H型高血压组患者的血清Hcy、炎症因子及斑块稳定性指标含量与对照组比较,差异有统计学意义(P<0.05),其中H型高血压组患者的血清Hcy,炎症因子人类软骨糖蛋白-39(HCGP-39)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β),斑块稳定性指标五聚素3(PTX3)、脂蛋白相关磷脂酶A2(Lp-PLA2)含量高于普通高血压组患者,斑块稳定性指标总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)含量低于普通高血压组患者。Pearson线性相关分析显示,H型高血压组患者的血清Hcy含量与炎症因子、斑块稳定性指标直接相关。结论血清Hcy含量升高是H型高血压合并颈动脉粥样硬化患者全身炎症反应加剧、斑块稳定性降低的重要影响因素。Objective To study the correlations of homocysteine(Hcy)with inflammatory factors and plaquestability in H-type hypertension patients combined with carotid atherosclerosis.Methods Ninety cases of H-typehypertensive patients combined with carotid atherosclerosis in our hospital from May2014to May2016weredivided into ordinary hypertension with carotid atherosclerosis group(normal blood pressure group,Hcy<10μmol/L,n=47)and H-type hypertension with carotid atherosclerosis group(H-type hypertension group,Hcy≥10μmol/L,n=43)according to serum Hcy content.A group of58healthy people who underwent medical examinationwere chosen as control group.Serum content of Hcy,inflammatory cytokines and plaque stability indices weredetected.The correlations of Hcy content with inflammatory factors and plaque stability indices were furtheranalyzed.Results Serum content of Hcy,inflammatory cytokines and plaque stability indices in the normal bloodpressure group and the H-type hypertension group were significantly different from those in the control group(P<0.05).Serum Hcy,human cartilage glycoprotein factor-39,TNF-α,hypersensitive C-reactive protein,IL-1β,pentamer3,lipoprotein-associated phospholipase A2in the H-type hypertension group were higher than those in thenormal blood pressure group(P<0.05);while the content of total bilirubin,direct bilirubin and indirect bilirubin inthe H-type hypertension group were lower than those in the normal blood pressure group(P<0.05).Pearson linearcorrelation analysis revealed that serum Hcy content in the H-type hypertension group had direct correlations withinflammatory cytokines and plaque stability indicators.Conclusions High level of Hcy is an important factor whichaggravates systemic inflammatory response and reduces plaque stability in H-type hypertension patients combinedwith carotid atherosclerosis.

关 键 词：H型高血压 颈动脉粥样硬化 同型半胱氨酸 炎症因子 斑块稳定性 

分 类 号：R544.1[医药卫生—心血管疾病]