社区老年高同型半胱氨酸血症与高血压的关系研究

摘要

目的：探讨高同型半胱氨酸血症(hHcy)与高血压的关系。方法：选取笔者所在社区的88例老年hHcy原发性高血压患者作为研究对象，其中单纯原发性高血压21例(A组)、原发病高血压合并冠心病23例(B组)，原发性高血压合并脑梗死18例(C组)，原发性高血压合并糖尿病26例(D组)，另选取22例健康老年人作为对照组，对几组患者的血压、血糖、血脂等指标进行比较、分析。结果：对照组各项血糖、血脂、血压指标与病例组比较，差异均有统计学意义(P<0.05)；各病例组的Hcy水平均显著高于对照组(P<0.05)，VB12水平均显著低于对照组(P<0.05)。A组的DBP、VB12、FA、Cr、FPG与其他各组比较，差异均有统计学意义(P<0.05)。多元回归分析显示Hcy与SBP、DBP呈正相关(r=0.433、0.389)。结论：高Hcy血症是原发性高血压的独立危险因素，单纯原发性高血压患者的维生素B12(VB12)、叶酸水平相对较高，合并糖尿病、脑梗死、冠心病者的VB12、叶酸水平均有不同程度下降。%Objective:To investigate the relationship between hyperhomocysteinemia(hHcy) and hypertension.Method: 88 cases of elderly patients with hHcy level and the community hypertension were selected as the research object, in which simplex essential hypertension in 21 cases (A group), 23 patients with the essential hypertension and coronary heart disease(B group),18 cases of essential hypertension complicated with cerebral infarction (C group),26 cases of essential hypertension with diabetes mellitus(D group),the other 22 cases of healthy elderly people were selected as the control group.The blood glucose, blood lipid,blood pressure indexes of the several groups patients were compared and analyzed.Result:The blood glucose,blood lipid, blood pressure indexs of the control group and the case group were significant difference(P<0.05);the level of Hcy in the case group were significantly higher than those of the control group(P<0.05), the level of VB12 were significantly lower than those of the control group(P<0.05).A group of DBP, VB12, FA, Cr, FPG and the other groups had significant difference(P<0.05).Multiple regression analysis showed that Hcy was positively correlated with SBP, DBP(r=0.433,0.389).Conclusion: The hHcy level is an independent risk factor of hypertension, simplex essential hypertension in patients with VB12, folic acid level is relatively high, diabetes, cerebral infarction, coronary heart disease, folic acid level of VB12 decreased in different degrees.