高血压患者同型半胱氨酸水平与动脉粥样硬化的相关关系  

Correlation between homocysteine level and atherosclerosis among patients with hypertension

作　　者：左惠娟[1] 邓利群[2] 王锦纹[1] 杨红霞[3] 宋现涛[3] ZUO Huijuan;DENG Liqun;WANG Jinwen;YANG Hongxia;SONG Xiantao(Department of Research Community Health and Prevention,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所人群防治研究室,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所全科医疗科,100029 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029

出　　处：《心肺血管病杂志》2020年第3期260-263,275,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市卫生和计划生育委员会科技成果和适宜技术推广项目(TG-2015-33)。

摘　　要：目的:了解高血压患者同型半胱氨酸(HCY)水平以及颈动脉斑块的检出率,评价HCY水平与动脉粥样硬化的相关关系。方法:收集2016年6月至2017年6月,在北京安贞医院就诊且进行颈动脉超声的高血压患者3 962例。结果:HCY平均水平为17.91μmol/L,64.5%的患者HCY水平超过15μmol/L。颈动脉斑块的检出率为50.5%,心血管疾病患病率为12.9%;没有颈动脉斑块和心血管疾病的患者、单纯颈动脉斑块患者以及单纯心血管疾病患者性别、年龄、高血压病程、HCY水平、收缩压、FPG、LDL-C、吸烟、饮酒、缺乏体育锻炼等差异有统计学意义;HCY水平预测颈动脉斑块曲线下面积为:0.666 (95%CI:0.642~0.694,P<0.001),预测心血管病的曲线下面积为0.566(95%CI:0.540~0.592,P<0.001);调整性别、年龄、高血压病程、腰围、FPG、糖尿病、LDL-C水平、吸烟、饮酒、缺乏体育锻炼、血压控制的影响后,HCY水平与颈动脉斑块具有显著的相关关系,相对危险度为1.207(95%CI:1.147~1.376,P=0.012)与心血管疾病没有显著的相关关系,相对危险度为1.198(95%CI:0.962~1.492,P=0.106)。结论:HCY水平升高是高血压患者一个显著特征,50%高血压患者中检出颈动脉斑块,HCY水平升高与颈动脉斑块的发生具有显著相关关系,但与心血管疾病的相关关系,差异无统计学意义。Objective: This study aimed to describe the status of carotid plaque and the relationship between homocysteine level and atherosclerosis in patients with hypertension. Methods: This cross-sectional survey was conducted between June 2016 and June 2017. 3962 patients with hypertension who were assessed carotid plaque by Color Doppler ultrasonography at Anzhen Hospital enrolled in the study. Results: The mean level of homocysteine was 17.91 μmol/L, and 64.5% had high homocysteine blood level which was≥15 μmol/L. 1997 of 3962 patients were examined carotid plaque, and 12.9% had history of cardiovascular disease. The significant difference of sex, age, duration of hypertension, waist circumference, plasma glucose level, LDL-C, homocysteine level, current smoking, lack of physical activity, and blood pressure control was found among patients without carotid plaque or CVD, patients with carotid plaque only and patients with CVD. The AUC-values of carotid plaque and CVD predicting for homocysteine was 0.666(95%CI: 0.642-0.694, P<0.001) and 0.566(95%CI: 0.540-0.592, P<0.001), respectively. Carotid plaque was correlated with homocysteine level,(OR=1.207,95%CI:1.147-1.376,P=0.012) after adjustment for sex, age, duration of hypertension, waist circumference, diabetes,LDL-C, current smoking, lack of physical activity, and blood pressure control, but no significant correlation was found between homocysteine level and CVD, OR was 1.198(95%CI:0.962-1.492,P=0.106). Conclusions: Homocysteine raise was a significant characteristics, half of patients with hypertension were detected carotid plaque;homocysteine blood level was associated with the presence of carotid plaque, but didn′t show significant correlation with CVD.

关 键 词：同型半胱氨酸 动脉粥样硬化 颈动脉斑块 心血管疾病 

分 类 号：R54[医药卫生—心血管疾病]