血浆同型半胱氨酸、D-二聚体水平与原发性高血压患者颈动脉内膜中膜厚度的相关性研究

摘要

Objective To analyze the correlation between plasma level of homocysteine,of D-dimer and carotid intima-media thickness (cIMT) of patients with essential hypertension.Methods From April 2014 to April 2016,a total of 492 patients confirmed as essential hypertension was selected in the Department of Cardiology,Electric Power Hospital of Shanghai,and they were divided into A group (with normal cIMT,n =200),B group (with thickening of cIMT,n =223)and C group (with plaque formation,n =69) according to cIMT General information,FBG,blood lipids index,plasma levels of homocysteine and D-dimer were compared among the three groups,and correlation between plasma of homocysteine,of D-dimer and cIMT of patients with essential hypertension were analyzed,respectively.Results No statistically significant differences of gender,body mass,FBG,HDL-C or LDL-C was found among the three groups (P ＞0.05),while there were statistically significant differences of age,disease course,TC and TG (P ＜ 0.05).Plasma levels of homocysteine and D-dimer of B group and C group were statistically significantly higher than those of A group,meanwhile plasma levels of homocysteine and D-dimer of C group were statistically significantly higher than those of B group (P ＜ 0.05).Partial correlation analysis results showed that,plasma homocysteine level was positively correlated with cIMT after correction of age,disease course,TC,TG and plasma D-dimer level (r =0.58,P ＜ 0.05),meanwhile plasma D-dimer was positively correlated with cIMT after correction of age,disease course,TC,TG and plasma homocysteine level (r =0.29,P ＜ 0.05).Conclusion Elevation of plasma level of homocysteine,of D-dimer is positively correlated with the thickening of cIMT,respectively.%目的 分析血浆同型半胱氨酸(Hcy)、D-二聚体水平与原发性高血压(EH)患者颈动脉内膜中膜厚度(cIMT)的相关性.方法 选取2014年4月-2016年4月在上海电力医院心内科确诊的EH患者492例,根据cIMT分为正常组200例、增厚组223例和斑块组69例.比较3组患者一般资料、空腹血糖、血脂指标及血浆Hcy、D-二聚体水平,并分析血浆Hcy、D-二聚体水平与EH患者cIMT的相关性.结果 3组患者性别和体质量比较,差异无统计学意义(P＞0.05);3组患者年龄和病程比较,差异有统计学意义(P＜0.05).3组患者空腹血糖及高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异无统计学意义(P＞0.05);3组患者总胆固醇(TC)、三酰甘油(TG)水平比较,差异有统计学意义(P＜0.05).增厚组和斑块组患者血浆Hcy和D-二聚体水平高于正常组,斑块组患者血浆Hcy和D-二聚体水平高于增厚组(P＜0.05).偏相关分析结果显示,校正年龄、病程、TC、TG、D-二聚体后,血浆Hcy水平与cIMT呈正相关(r=0.58,P＜0.05);校正年龄、病程、TC、TG、Hcy后,血浆D-二聚体水平与cIMT呈正相关(r=0.29,P＜0.05).结论 血浆Hcy和D-二聚体水平升高均与EH患者cIMT增厚呈正相关.