高血压合并冠心病患者血浆中同型半胱氨酸水平与颈动脉硬化的相关性  

Correlation between plasma homocysteine level and carotid atherosclerosis in patients with hypertension and coronary heart disease

作　　者：冯六六[1] 黄红漫[1] 刘新兵[1] 白艳艳[1] 史骏[1] 杨玉亚[1] 肖文颖[1] 刘天华[1] FENG Liuliu;HUANG Hongman;LIU Xinbing;BAI Yanyan;SHI Jun;YANG Yuya;XIAO Wenying;LIU Tianhua(Department of Cardiology,East City Hospital of Shanghai Yangpu District,Shanghai 200438,China)

机构地区：[1]上海市杨浦区市东医院心内科,上海200438

出　　处：《实用医学杂志》2018年第18期3055-3059,共5页The Journal of Practical Medicine

基　　金：上海市医学重点专科建设项目(编号:ZK2015B23)

摘　　要：目的观察高血压合并冠心病患者血浆中同型半胱氨酸(HCY)与颈动脉硬化(CAS)的相关性。方法采用等距随机抽样法纳入2014年1月至2018年1月于收治的236例原发性高血压患者为对象,按照合并冠心病情况将其分为两组,即A组(单纯高血压组,116例)、B组(高血压合并冠心病组,120例)。抽取空腹肘静脉血,采用全自动生化分析仪检测HCY水平及相关生化指标,同时行颈动脉超声检查,检测颈动脉内膜中层厚度(IMT)。统计两组患者一般资料、病理学资料,包括空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、尿酸(UA)、尿素氮(BUN)、肌酐(Cr)等,观察血浆HCY及颈动脉IMT水平,分析颈动脉粥样硬化检出情况,探究血浆中HCY水平与IMT的相关性。结果两组年龄、性别及TC、TG、LDL-C、BUN水平比较差异无统计学意义(P> 0.05);A组吸烟所占比例、FPG、Cr、UA水平显著低于B组(P <0.05),且HDL-C水平显著高于B组(P <0.05)。A组HCY、IMT水平显著低于B组(P <0.05)。A组IMT正常所占比例显著高于B组(P <0.05),且斑块形成所占比例显著低于B组(P <0.05)。经直线相关分析显示,高血压合并冠心病患者血浆中HCY水平与颈动脉IMT水平呈正相关(r=0.896,P=0.037)。结论血浆HCY水平升高是高血压合并冠心病患者颈动脉粥样硬化的重要影响因素,临床应引起足够重视。Objective To observe the correlation between plasma homocysteine(HCY)and carotid ath-erosclerosis(CAS)in patients with hypertension and coronary heart disease.Methods 236 patients with primary hypertension treated in our hospital from January 2014 to January 2018 were divided into two groups,namely group A(simple hypertension group,116 patients)and group B(hypertension complicated by coronary heart disease group,120 patients).HCY level and related biochemical indexes were detected by an automatic biochemical ana-lyzer,and carotid artery intima-media thickness(IMT)was detected by ultrasonic examination.The general data and pathological data of the two groups were collected,including fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),uric acid(UA),urea nitrogen(BUN),and creatinine(Cr).Level of plasma HCY and carotid artery IMT were observed.Detection level of atherosclerosis was analyzed and the correlation between plasma HCY level and IMT was explored.Re-sults There was no significant difference in age,sex and TC,TG,LDL-C and BUN between the two groups(P>0.05).The proportion of smoking,FPG,Cr and UA were significantly lower in group A than in group B(P<0.05),but HDL-C level was significantly higher(P<0.05).Levels of HCY and IMT in group A were significantly lower than those in group B(P<0.05).The proportion of normal IMT was significantly higher in group A than in group B(P<0.05),while the proportion of plaque formation was significantly lower(P<0.05).Linear correla-tion analysis showed that plasma HCY level was positively correlated with carotid IMT level in patients with hyper-tension and coronary heart disease(r=0.896,P=0.037).Conclusions Elevated plasma HCY level is an impor-tant influencing factor of carotid atherosclerosis in patients with hypertension and coronary heart disease,so we should pay enough attention to it.

关 键 词：高血压 冠心病 同型半胱氨酸 颈动脉硬化 

分 类 号：R544.1[医药卫生—心血管疾病]