H型高血压患者血清Hcy、Cys-C及颈动脉粥样硬化与24h动态血压变异性的关系  

Relationship between 24 h ambulatory blood pressure variability and serum Hcy,Cys-C,carotid atherosclerosis in patients with H-type hypertension

作　　者：付灵芝 唐海燕[2] FU Lingzhi;TANG Haiyan(Department of Geriatrics,Rehabilitation Hospital,Social Welfare Center,Nanhai District,Foshan City,Foshan,Guangdong 528226,China;Department of Infectious Diseases,Daqing Oilfield General Hospital,Daqing,Heilongjiang 163000,China)

机构地区：[1]佛山市南海区社会福利中心康复医院老年病科,广东佛山528226 [2]大庆油田总医院感染性疾病科,黑龙江大庆163000

出　　处：《现代医药卫生》2020年第12期1827-1830,共4页Journal of Modern Medicine & Health

摘　　要：目的分析H型高血压患者血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)及颈动脉粥样硬化与24h动态血压变异性的关系。方法将佛山市南海区社会福利中心康复医院2017年1月至2018年12月收治的155例H型高血压患者作为研究组,并选择86例非H型高血压患者为对照组,比较2组患者基本资料、血生化指标、24h动态血压变异性及颈动脉内膜中层厚度(cIMT)。根据研究组患者cIMT的不同,分为A组(cIMT正常,n=42)、B组(cIMT增厚,n=54)、C组(颈动脉斑块形成,n=59),比较3组患者24h动态血压监测结果,分析血压变异性与其他临床指标的关系。结果相比对照组,研究组血清Hcy、CysC、低密度脂蛋白胆固醇(LDL-C)、24h平均收缩压(24hSBP)、24h平均舒张压(24hDBP)、24h收缩压变异系数(24hSBP-CV)、24h舒张压变异系数(24hDBP-CV)及cIMT值均明显升高,颈动脉粥样硬化发生率也明显升高,差异均有统计学意义(P<0.05)。相比A组,B、C组24hSBP、24hDBP、24hSBP-CV和24hDBP-CV均明显升高,差异均有统计学意义(P<0.05)。H型高血压患者血清Hcy、Cys-C与24hSBP-CV呈正相关(P<0.05),血清Hcy与24hDBP-CV呈正相关(P<0.05),血清Cys-C与24hSBP、24hDBP呈正相关(P<0.05),cIMT与24hSBP呈正相关(P<0.05)。结论H型高血压患者血清Hcy和Cys-C含量明显升高,发生颈动脉粥样硬化的风险性明显升高,且血清Hcy、Cys-C、颈动脉粥样硬化与患者血压变异性存在密切关系。Objective To analyze the relationship between 24 h ambulatory blood pressure variability and serum homocysteine(Hcy),cystatin C(Cys-C),carotid atherosclerosis in patients with H-type hypertension.Methods A total of 155 patients with H-type hypertension in Rehabilitation Hospital,Social Welfare Center,Nanhai District,Foshan City from January 2017 to December 2018 were selected as the study group,and 86 patients with non-H-type hypertension in the same period were selected as the control group.The basic data,blood biochemistry indexes,24 h ambulatory blood pressure variability and carotid intima-media thickness(cIMT)were compared between the two groups.According to the difference of cIMT in the study group,the patients were divided into three groups:group A(normal cIMT,n=42),group B(thickening of cIMT,n=54)and group C(carotid plaque formation,n=59).The 24 h ambulatory blood pressure monitoring results of the three groups were compared,and the relationship between blood pressure variability and other clinical indicators were analyzed.Results Compared with the control group,the serum levels of Hcy,Cys-C,low density lipoprotein cholesterol(LDL-C),24 h mean systolic blood pressure(24 hSBP),24 h mean diastolic blood pressure(24 hDBP),24 h systolic blood pressure coefficient variation(24 hSBP-CV),24 h diastolic blood pressure coefficient variation(24 hDBP-CV)and cIMT in the study group were significantly increased,and the incidence of carotid atherosclerosis was significantly higher,the differences were statistically significant(P<0.05).Compared with group A,24 hSBP,24 hDBP,24 hSBP-CV and 24 hDBP-CV in group B and C increased significantly,the differences were statistically significant(P<0.05).Serum Hcy and Cys-C were positively correlated with 24 hSBP-CV(P<0.05),serum Hcy was positively correlated with 24 hDBP-CV(P<0.05),serum Cys-C were positively correlated with 24 hSBP and 24 hDBP(P<0.05),and cIMT was positively correlated with 24 hSBP(P<0.05).Conclusions The levels of serum Hcy and Cys-C in patients with H-type hype

关 键 词：H型高血压 血压变异性 颈动脉粥样硬化 同型半胱氨酸 胱抑素C 

分 类 号：R544.1[医药卫生—心血管疾病]