中青年难治性高血压患者Hcy水平与中心动脉压、cfPWV、AIx及RHI的关系  

Relationship between different Hcy levels and central arterial pressure,cfP WV,AIx and RHI in middle-aged and young patients with refractory hypertension

作　　者：张有霞 马静 何淑珍[2] ZHANG You-xia;MA Jing;HE Shu-zhen(Department of coronary heart disease Qinghai Special Hospital for Cardiovascular and Cerebrovascular Diseases,Xining Qinghai 810001,China;Department of Public Health,Xining City Center for Disease Control and Prevention,Xining Qinghai 810001,China)

机构地区：[1]青海省心脑血管病专科医院冠心病科,青海西宁810001 [2]西宁市疾病预防控制中心公共卫生科,青海西宁810001

出　　处：《临床和实验医学杂志》2020年第17期1807-1811,共5页Journal of Clinical and Experimental Medicine

基　　金：青海省科技厅资助项目(编号:9632019J0360)。

摘　　要：目的探讨中青年难治性高血压患者同型半胱氨酸(Hcy)水平与中心动脉压、颈-股动脉脉搏传导速度(cfPWV)、中心动脉增强指数(AIx)及内皮功能指数(RHI)的关系。方法采用前瞻性研究方法,选取2017年5月至2019年5月青海省心脑血管病专科医院收治的中青年难治性高血压患者共100例作为A组,同时选取100例血压控制达标的高血压患者作为B组,以及100例血压正常者作为C组,分别以血清Hcy <10μmol/L(正常)和≥10μmol/L(升高)进行分层分析。分别对各组人员的中心动脉压、cfPWV、AIx及RHI指标数据进行检测并做统计分析,同时采用多元线性回归分析,梳理Hcy水平与相关指标的相关性。结果 A组患者中,具有高Hcy水平患者的cfPWV和RHI都要高于具有正常Hcy水平的患者,差异具有统计学意义(P <0.05),而其中心动脉压和AIx指数的对比差异无统计学意义(P>0.05);在B组和C组的对比结果中,高Hcy水平组和正常Hcy水平组中心动脉压、cfPWV、AIx及RHI的差异无统计学意义(P>0.05)。在A组患者中,Hcy与cfPWV之间呈正相关关系(r=0.323,P <0.05);在总人群中,Hcy与cfPWV之间呈正相关关系(r=0.212,P <0.05)。在对混杂因素调整后,Hcy与cfPWV之间仍然呈正相关关系(r=0.319、361,P<0.05),中青年难治性高血压患者血清Hcy水平与cfPWV指标呈正相关关系,采用多元线性回归分析得出,中青年难治性高血压患者的Hcy是cfPWV的独立危险因素。结论中青年难治性高血压患者的血清高Hcy水平是引起cfPWV变化的独立危险因素,会加快动脉硬化的发展。Objective To investigate the relationship between homocysteine (Hcy) levels and central arterial pressure,carotid-femoral pulse wave velocity (cf PWV),central arterial augmentation index (AIx) and reactive hyperemia index (RHI) in middle-aged and young patients with refractory hypertension.Methods A prospective study was conducted to select a total of 100 middle-aged and young patients with refractory hypertension who were admitted to Qinghai Provincial Cardiovascular and Cerebrovascular Specialty Hospital from May 2017 to May 2019 as group A,and 100 hypertensive patients with blood pressure controlled to normal standards were selected as group B and 100 patients with normal blood pressure were selected as group C.The stratified analysis was performed with serum Hcy<10μmol/L (normal) and≥10μmol/L (elevated).The central arterial pressure,cf PWV,AIx,and RHI data of each group were detected and statistically analyzed.At the same time,multiple linear regression analysis was used to analyze the correlation between Hcy levels and related indicators.Results In group A,patients with high Hcy level had higher cf PWV and RHI than those with normal Hcy level,the difference was statistically significant (P<0.05);there was no statistically significant difference in central arterial pressure and AIx (P>0.05).In group B and C,there was no significant difference in central arterial pressure,cf PWV,AIx,and RHI between the high Hcy level group and the normal Hcy level group (P>0.05).In group A,Hcy level was positively correlated with cf PWV (r=0.323,P<0.05);in the general population,Hcy level was positively correlated with cf PWV (r=0.212,P<0.05).After adjusting for confounding factors,Hcy level was still positively correlated with cf PWV (r=0.319,361,P<0.05).The serum Hcy level of middle-aged and young patients with refractory hypertension showed a positive correlation with cf PWV.Multiple linear regression analysis showed that Hcy was an independent risk factor for cf PWV in middle-aged and young patients with refractory hyp

关 键 词：难治性高血压 同型半胱氨酸 颈-股动脉脉搏传导速度 中心动脉增强指数 内皮功能指数 

分 类 号：R544.1[医药卫生—心血管疾病]