老年高血压患者颈动脉粥样硬化与血清同型半胱氨酸、脂蛋白（a）、尿酸的关系

摘要

Objective To investigate the relationship between intima⁃media thickness ( IMT ) and levels of serum homocysteine( Hcy) ,lipoprotein( a) [ Lp( a) ] and uric acid ( UA) in the elderly patients with hypertension. Methods Sixty elderly hypertensive patients were divided into three groups according to the degree of carotid artery atherosclerosis:normal IMT group ( IMT≤0�9 mm,16 cases) , thickening IMT group ( IMT 1�0⁃1�3 mm,19 cases) and plaque formation group(IMT≥1�4 mm,25 cases). The level of Lp(a) was evaluated by emulsion turbidity method. Hcy was evaluated by chemiluminescence method.UA was evaluated by continuous monitoring method. The levels of Lp(a), Hcy and UA were compared among 3 groups. Results The levels of Hcy, Lp( a) and UA were highest in plaque formation group,followed by thickening IMT group and normal IMT group(P<0�05).There was a significant positive relationship between serum level of Hcy and UA,between serum level of hcy and Lp(a), between serum level of Lp(a) and UA in thickening IMT group (r=0�65,0�63,0�67 P<0�05)and plaque formation group (r=0�70,0�67,0�65,P<0�05). Conclusions There is a closely relationship between Hcy, Lp ( a ) , UA concentration and the degree of carotid artery atherosclerosis in elderly patients with hypertension.%目的探讨血清同型半胱氨酸（ Hcy）、脂蛋白（ a）[ Lp（ a）]、尿酸（ UA）水平与老年高血压患者颈动脉粥样硬化程度的关系。方法将60例高血压患者根据颈动脉粥样硬化的程度分为3组：颈动脉内膜中层厚度（IMT）正常组（IMT≤0�9 mm）（16例）、颈动脉 IMT 增厚组（IMT 1�0～1�3 mm）（19例）和颈动脉斑块形成组（IMT≥1�4 mm）（25例）。使用全自动生化分析仪，采用乳胶浊度法测定3组患者Lp（a）水平，采用化学发光法测定3组患者Hcy水平，采用酶连续监测法测定3组患者UA水平。结果颈动脉IMT增厚组、颈动脉IMT斑块形成组血清Hcy、Lp（ a）、UA水平均明显高于颈动脉IMT正常组（ P均＜0�05），颈动脉IMT斑块形成组血清Hcy、Lp （ a）、UA水平明显高于颈动脉IMT增厚组（ P＜0�05）。颈动脉IMT增厚组和颈动脉斑块形成组中患者血清Hcy水平与UA水平呈正相关（r＝0�65、0�70，P＜0�05），Hcy水平与Lp（a）水平呈正相关（r＝0�63、0�67，P＜0�05），Lp（a）水平与UA水平呈正相关（ r＝0�67、0�65，P＜0�05）。结论老年高血压患者血清Hcy、Lp（ a）、UA水平升高与颈动脉粥样硬化密切相关。