高血压病患者血浆同型半胱氨酸水平与动脉硬化的相关性分析

摘要

目的 探讨高血压病患者血浆同型半胱氨酸(homocysteine,Hcy)水平与动脉硬化的相关性.方法 入选420例高血压病患者及192例健康体检人员作为研究对象,健康体检人员作为对照组,高血压病患者根据血浆Hcy水平分为Hcy正常组、Hcy轻度升高组、Hcy显著升高组.应用自动脉搏波速度测定仪测定颈动脉-股动脉脉搏波速度(CFPwV)作为评估动脉硬化的参数.比较4组血压参数、Hcy水平及CFPwV水平,计算各组动脉硬化发生率;将高血压病患者的各因素与CFPwV进行Pearson相关分析及多元线性回归分析.结果 (1)与对照组比较,血压各参数、Hcy及CFPwV在Hcy正常组、Hcy轻度升高组、Hcy显著升高组中均明显升高(P<0.05).与Hcy正常组比较,血压各参数、Hcy及CFPwV在Hcy轻度升高组、Hcy显著升高组中明显升高(P<0.05).与Hcy轻度升高组比较,Hcy显著升高组收缩压(SBP)、Hcy、CFPwV明显增高(P<0.05);(2)动脉硬化的发生率在Hcy轻度升高组、Hcy显著升高组中高于Hcy正常组(P<0.05);(3)Pearson相关分析显示,高血压患者的CFPwV与年龄、SBP、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)、Hcy呈正相关(P<0.01);多元线性回归分析结果显示Hcy、SBP、PP是CFPwV的独立影响因素.结论 Hcy、SBP、PP是CFPwV的独立影响因素,高Hcy水平与高血压具有协同作用,放大了高血压导致动脉硬化的风险,并共同参与动脉硬化的发生发展.%Objective To study the correlation between homocysteine (Hcy) level and arteriosclerosis in hypertension pa-tients.Methods Four hundred and twenty hypertension patients (assigned as the experimental group) and 192 healthy examinees (as-signed as the control group) were recruited for the study, and the hypertension patients were further subdivided into the normal Hcy group, the slightly higher Hcy group and the obviously high Hcy group, in accordance with the plasma levels of Hcy.Carotid-femoral pulse wave velocity ( CFPwV) was measured by automatic pulse wave velocity detector and was used as an arteriosclerosis indicator. Blood pressure parameters, Hcy levels, CFPwV levels were compared between the 4 groups and the incidence of atherosclerosis for each group were calculated accordingly.Then, Pearson correlation analysis and multiple regression analysis were performed in all the associ-ated factors of hypertension with CFPwV.Results (1) As compared with those of the control group, the levels of systolic blood pres-sure ( SBP) , diastolic blood pressure ( DBP) , mean arterial blood pressure ( MAP) , pulse pressure ( PP) , Hcy and CFPwV increased in all the experimental groups (P<0.05).As compared with those of the Hcy normal group, the levels of SBP, DBP, MAP, PP, Hcy and CFPwV increased in the slightly higher Hcy group and the obviously high Hcy group (P<0.05).And as compared with those of the slightly higher Hcy group, the levels of SBP, Hcy and CFPwV in the obviously high Hcy group all elevated significantly ( P<0.05).(2) The incidence of atherosclerosis in the slightly higher Hcy group and the obviously high Hcy group was higher than those of the normal Hcy group (P<0.05).(3) Pearson correlation analysis revealed that CFPwV was positively correlated with age, SBP, DBP, PP, MAP and Hcy.Results of multiple linear regression analysis indicated that Hcy, SBP and PP were independent influential factors of CFPwV.Conclusion Hcy, SBP and PP were independent influential factors of CFPwV.High Hcy level and hypertension were synergistic, and high Hcy could increase the risk of atherosclerosis due to hypertension, indicating that hypertension and high Hcy level were all involved in the occurrence and development of atherosclerosis.