青海省高原地区老年高血压病人血清同型半胱氨酸水平与动脉硬化的关系

摘要

Objective To investigate the relationship of serum level of homocysteine (Hcy) and arterial stiffness in elderly patients with hypertension in the high altitude region of Qinghai province.Methods According to the levels of Hcy and blood pressure, one hundred and nineteen elderly patients were divided into H type hypertension group (n=58), non-H type hypertension group (n=31) and healthy control group (n=30).The Colin-VP1000 type artery stiff diagnosis apparatus was used to measure brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI), while the serum level of Hcy was measured through ELISA.Results Compared with non-H type hypertension group and healthy control group, H type hypertension group showed higher levels of serum Hcy and BaPWV (P<0.05), and lower level of ABI (P<0.05).The serum Hcy level was negatively related with ABI and positively related with BaPWV (r=-0.739, P<0.01;r=0.927, P<0.01) in H type hypertension group.Conclusions The serum Hcy level is closely correlated to BaPWV and ABI in elderly patients with hypertension.The increased serum Hcy level may play an important role in the impairment of artery function in elderly patients with H type hypertension.%目的 探讨青海省高原地区(平均海拔3,200 m)老年高血压病人血清同型半胱氨酸(homocysteine,Hcy)水平与动脉硬化的关系. 方法 收集老年高血压病人89例,其中伴有高Hcy者 58 例,单纯高血压病人31例,同期门诊健康体检者30例;对所有研究对象进行血生化及血清Hcy水平检测,并用日本Colin-VPl000 型动脉硬化仪测量肱-踝脉搏波传导速度(BaPWV)和踝臂指数(ABI),对所有检测结果进行统计学分析. 结果 与正常对照组及单纯高血压组比较,H型高血压组BaPWV、Hcy明显升高,而ABI则明显降低,差异有统计学意义(P<0.05).相关性分析显示,H型高血压组Hcy与ABI呈负相关(r=-0.739,P<0.01),与BaPWV呈正相关(r=0.927,P<0.01). 结论 血清Hcy水平增高是高原地区老年高血压发病的危险因素之一,H型高血压病人较单纯高血压病人动脉硬化严重,可能与血清Hcy水平与高血压在导致动脉硬化方面具有协同作用有关.