H 型高血压与冠心病、脑梗死的关系研究

摘要

Objective To study the correlation between H - type hypertension and coronary heart disease( CHD) and cerebral infarction(CI). Methods From October 2012 to September 2013,124 patients with H - type hypertension were selected in our hospital. According to the examination results of coronary arteriography and brain MRI,the above patients were divided into four groups:H - type hypertension group(n = 62),CHD group( n = 32),CI group( n = 30),CHD and CI group(n = 12). Blood pressure were measured,serum homocysteine level,blood liquid and blood glucose were detected in the four groups. Results Univariate analysis results showed that,there was no significant differences of blood pressure,blood glu-cose,serum levels of total cholesterol and triacylglycerol in the four groups( P > 0. 05);serum homocysteine level of CHD group,CI group,CHD and CI group was higher than that of H - type hypertension group,respectively,CHD and CI group was higher than that of CHD group,CI group,respectively(P < 0. 05). Linear correlation analysis showed that,serum homocys-teine level was positively correlated with degree of coronary artery stenosis,cerebral infarction size( r = 0. 780,0. 802,P <0. 05),respectively. Multivariate Logistic regression analysis results showed that,higher serum homocysteine level was a risk fac-tor of CHD〔OR = 4. 235,95% CI(1. 386,16. 852),P = 0. 014〕,CI〔 OR = 3. 086,95% CI(1. 003,13. 206),P =0. 047〕,respectively. Conclusion Higher serum homocysteine level was an independent risk factor of CHD or CI in patients with hypertension,H - type hypertension has certain correlation with CHD and CI.%目的：探讨 H 型高血压与冠心病、脑梗死的关系。方法选取我院2012年10月-2013年9月收治的H 型高血压患者136例，根据冠状动脉造影、颅脑 MRI 检查结果分为4组：H 型高血压组62例，冠心病组32例，脑梗死组30例，冠心病并脑梗死组12例。测量各组患者血压，测定其血浆同型半胱氨酸水平、血脂、血糖等。结果单因素分析结果显示，各组血压、血糖及血浆总胆固醇、三酰甘油水平比较，差异均无统计学意义（P >0.05）；冠心病组、脑梗死组、冠心病并脑梗死组血浆同型半胱氨酸水平高于 H 型高血压组，冠心病并脑梗死组高于冠心病组、脑梗死组（P <0.05）。直线相关性分析结果显示，高血压患者血浆同型半胱氨酸水平与冠状动脉狭窄程度、脑梗死灶大小均呈正相关（r =0.780、0.802，P <0.05）。多因素 Logistic 回归分析结果显示，血浆同型半胱氨酸水平升高是冠心病〔OR =4.235，95% CI（1.386，16.852），P =0.014〕、脑梗死〔 OR =3.086，95% CI（1.003，13.206），P =0.047〕的独立危险因素。结论高血压患者血浆同型半胱氨酸水平升高是冠心病、脑梗死的独立危险因素，H 型高血压与冠心病、脑梗死密切相关。