H型高血压与急性脑梗死患者颈动脉内膜中层厚度及功能的相关性分析

摘要

Objective:To explore the correlation of carotid intima media thickness with function in patients with H-type hypertension and acute cerebral infarction.Methods:A total of 150 patients with acute cerebral infarction who were admitted in our hospital from June,2016 to June,2017 were included in the study and divided into H-type hypertension group (H-type hy-pertension merged with acute cerebral infarction,Hcy≥10 μmol/L),non-H-type hypertension group (non-H-type hyperten-sion merged with acute cerebral infarction,Hcy≥10 μmol/L),and the control group (no hypertension but with acute cerebral infarction)according to Hcy level and whether being suffered from hypertension or not with 50 cases in each group.Moreover,50 healthy individuals who came for physical examinations were served as the healthy group.The morning fasting peripheral ve-nous blood was collected at physical examination time for patients in the healthy group and after admission for patients with a-cute cerebral infarction.Hcy,sICAM-1,MCP-1,and YKL-40 were detected.The color Doppler ultrasound diagnostic appara-tus was used to detect IMT,distensibility,and stiffness.Results:Hcy,MCP-1,sICAM-1,and YKL-40 levels in H-type hy-pertension group,non-H-type hypertension group,and the control group were significantly higher than those in the healthy group (P <0.05 ).Hcy,MCP-1,sICAM-1,and YKL-40 levels in H-type hypertension group and non-H-type hypertension group were significantly higher than those in the control group (P <0.05).Hcy,MCP-1,sICAM-1,and YKL-40 levels in H-type hypertension group were significantly higher than those in non-H-type hypertension group (P <0.05).IMT and stiffness in H-type hypertension group,non-H-type hypertension group,and the control group were significantly greater than those in the healthy group,while distensibility was significantly less than that in the healthy group (P <0.05).IMT and stiffness in H-type hypertension group and non-H-type hypertension group were significantly greater than those in the control group,while distensibility was significantly less than that in the control group (P <0.05).IMT and stiffness in H-type hypertension group were significantly greater than those in non-H-type hypertension group,while distensibility was significantly less than that in non-H-type hypertension group (P <0.05).Conclusions:Hcy can directly affect carotid AS,increase carotid IMT,and pro-mote the occurrence of hypertension merged with acute cerebral infarction;therefore,positive monitoring of serum Hcy level and IMT thickness in patients with hypertension and acute cerebral infarction and early intervention are of great significance in reducing the occurrence of carotid AS,delaying the progression of carotid AS,and preventing hypertension and acute cerebral infarction.%目的:探讨H型高血压与急性脑梗死患者颈动脉内膜中层厚度(IMT)及功能的相关性.方法:选取我院收治的急性脑梗死患者150例进行研究,依据同型半胱氨酸(Hcy)水平及有无高血压分为H型高血压合并急性脑梗死组(H型高血压组,Hcy≥10μmol/L)、非H型高血压合并急性脑梗死组(非H型高血压组,Hcy<10μmol/L)和对照组(无高血压急性脑梗死组)各50例,另选取同期健康体检志愿者50例为健康组.健康组于体检时、急性脑梗死患者于入院后,采集清晨空腹外周静脉血,测定Hcy、可溶性细胞间黏附分子-1(sICAM-1)、单核细胞趋化因子-1(MCP-1)、甲壳质酶蛋白40(YKL-40),采用彩色多普勒超声诊断仪测颈IMT、扩张性和僵硬度.结果:H型高血压组、非H型高血压组、对照组患者Hcy、MCP-1、sICAM-1、YKL-40水平明显高于健康组(P<0.05),H型高血压组、非H型高血压组患者Hcy、MCP-1、sICAM-1、YKL-40水平明显高于对照组(P<0.05),H型高血压组患者Hcy、MCP-1、sICAM-1、YKL-40水平高于非H型高血压组(P<0.05);H型高血压组、非H型高血压组、对照组患者IMT、僵硬度大于健康组,扩张性小于健康组(P<0.05),H型高血压组、非H型高血压组患者IMT、僵硬度大于对照组,扩张性小于对照组(P<0.05),H型高血压组患者IMT、僵硬度大于非H型高血压组,扩张性小于非H型高血压组(P<0.05).结论:Hcy可直接影响颈AS,增加颈IMT,促使高血压合并急性脑梗死的发生,因此积极监测高血压患者急性脑梗死高危人群血清Hcy水平和颈IMT厚度,及早进行干预,对减少颈AS发生、延缓颈AS的进展、预防高血压合并急性脑梗死有重要意义.