老年H型高血压颈动脉狭窄程度与血脂和炎性因子的相关性研究

摘要

Objective To explore the correlation between degree of carotid stenosis and lipids , inflammatory factors in elderly hy-pertensive patients with high homocysteine .Methods The 198 cases of elderly patients with hypertension were divided into high and low levels of H-hypertensive group [homocysteine (Hcy)≥10μmol/L, 104 cases] and simple hypertension group (Hcy<10μmol/L, 94 cases) according to plasma Hcy , and 100 healthy subjects were selected as the control group .The correlation between carotid stenosis and lipid, inflammatory factors were analyzed .Results Compared with the healthy control group , IMT, plaque index, stiffness, hs-CRP, IL-1, IL-6 and TNF-αin H hypertension and hypertensive groups were significantly increased , but the distensibility were decreased . Also, changes on these indicators of the degree of H -hypertensive group were significantly higher than the hypertension group ( P<0.05).Correlation analysis showed that the degree of stenosis of inflammatory cytokines and lipid levels were positively correlated (P<0.05).Multiple regression analysis showed that , Hcy, LDL cholesterol and hs -CRP were risk factors.Conclusion H-hypertensive patients are more prone to stenosis , which is closely related to lipid and inflammatory cytokine levels .%目的 探讨老年H型高血压颈动脉狭窄程度与血脂和炎性因子的相关性. 方法 将198例老年原发性高血压患者按照血浆同型半胱氨酸(homocysteine, Hcy)的水平高低分为H型高血压组(Hcy≥10μmol/L,n=104例)和单纯型高血压组( Hcy<10μmol/L,n=94) ,并以100例健康体检者为对照组,分析颈动脉狭窄程度与血脂和炎性因子的相关性. 结果 与健康对照组相比,H型高血压和单纯高血压组的IMT、斑块指数、僵硬度、hs-CRP、IL-1、IL-6和TNF-α均显著升高,扩张性明显降低,且H型高血压组的上述指标改变程度亦明显高于单纯高血压组( P<0.05);相关分析显示,颈动脉狭窄程度与炎性因子和血脂指标均呈正相关( P<0.05);多元回归分析显示,Hcy、低密度脂蛋白胆固醇和hs-CRP是高危因子. 结论 H型高血压患者更容易发生颈动脉狭窄,且与血脂和炎性因子水平密切相关.