H型高血压伴冠心病患者血浆Hcy、ADMA水平变化及临床意义  

Change and clinical significance of plasma Hcy and ADMA levels in patients with H-type hypertension and coronary heart disease

作　　者：郭华[1] 姜金钟[1] 苗维[2] 田守森[3] 王植荣[1] Guo Hua;Jiang Jinzhong;Miao Wei;Tian Shousen;Wang Zhirong(Internal Medicine-Cardiovascular Department,Cangzhou Hospital of integrated TCM-WM·HEBEI,Cangzhou,Hebei 061001)

机构地区：[1]沧州中西医结合医院心内科,沧州1061001 [2]沧州中西医结合医院康复科,沧州061001 [3]沧州中西医结合医院急诊科,沧州061001

出　　处：《中国循证心血管医学杂志》2019年第5期541-543,547,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省医学科学研究重点课题计划(20160394)

摘　　要：目的探讨H型高血压伴冠状动脉粥样硬化性心脏病(冠心病)患者血浆同型半胱氨酸(Hcy)、不对称性二甲基精氨酸(ADMA)水平变化及临床意义。方法选择高血压合并疑似或明确冠心病患者119例,入院后行冠状动脉(冠脉)造影术,采用Gensini积分法评价冠脉狭窄程度。采集患者一般资料和病史,检测三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、Hcy和ADMA。采用多因素Logistic回归分析冠心病发病的危险因素。结果H型高血压组Hcy、ADMA水平和冠心病患病率显著高于非H型高血压组(P均<0.05);H型高血压合并冠心病患者Gensini评分显著高于非H型高血压合并冠心病患者(P均<0.05);冠心病患者Hcy水平与ADMA水平和Gensini评分均呈正相关;多因素Logistic回归分析显示Hcy和ADMA是冠心病发病的独立危险因素。结论H型高血压合并冠心病患者Hcy和ADMA水平均显著升高,Hcy水平与ADMA水平和冠脉病变程度呈正相关,Hcy和AMDA均是冠心病发病的危险因素,检测Hcy和AMDA水平或可用于预测高血压患者冠心病发病风险和进展情况。Objective To study the changes and clinical significance of plasma Homocysteine (Hcy) and Asymmetric dimethylarginine (ADMA) levels in patients with H-type hypertension and coronary atherosclerotic heart disease (CHD). Methods A total of 119 patients with hypertension or suspected coronary heart disease were enrolled. Coronary angiography was performed after admission. The degree of coronary artery stenosis was evaluated by Gensini score. General patient data and medical history were collected,and fasting venous blood was collected for triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C), Hcy and ADMA. Multivariate logistic regression was used to analyze the risk factors of coronary heart disease. Results The prevalence of Hcy,ADMA and coronary heart disease in H-type hypertension group was significantly higher than that in non-H type hypertension group (P<0.05). The Gensini score of patients with H-type hypertension and coronary heart disease was significantly higher than that of patients with non-H-type hypertension and coronary heart disease (P<0.05). The level of Hcy in patients with coronary heart disease was positively correlated with ADMA level and Gensini score. Multivariate logistic regression analysis showed that Hcy and ADMA were independent risk factors for the onset of coronary heart disease. Conclusion The levels of Hcy and ADMA in patients with H-type hypertension and CHD were significantly increased,and Hcy level was positively correlated with ADMA level and severity of coronary lesions. Both Hcy and AMDA are risk factors for CHD. Detection of Hcy and AMDA can be used to predict the risk and progression of coronary heart disease in hypertensive patients.

关 键 词：高血压 同型半胱氨酸 冠心病 ADMA 

分 类 号：R544.1[医药卫生—心血管疾病]