老年高血压患者血同型半胱氨酸与脉搏波传导速度的关系

Relationship between pulse wave velocity and homocysteine in elderly patients with hypertension

目的探讨老年高血压患者血同型半胱氨酸(Hcy)与脉搏波传导速度的关系。方法将114例老年高血压患者按照血Hcy水平的高低分为2组:正常组61例,血Hcy≤15μmol/L;升高组53例,血Hcy>15μmol/L。分别测定2组患者的脉搏波传导速度、踝臂指数、空腹血糖、糖化血红蛋白、肌酐、尿酸、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、超敏C反应蛋白以及24 h平均血压。结果正常组和升高组的血Hcy水平分别为(11.71±1.88)μmol/L和(22.41±8.61)μmol/L(P<0.01),脉搏波传导速度分别为(1561±201)cm/s和(2150±476)cm/s(P<0.01),且升高组血肌酐水平明显高于正常组(P<0.05)。多元回归分析显示脉搏波传导速度与血Hcy水平有显著相关性(P<0.01)。结论老年高血压患者脉搏波传导速度的增快与高Hcy血症关系密切。

Objective To investigate the relationship between plasma homocysteine(Hcy) level and brachial-ankle pulse wave velocity(baPWV) in elderly patients with hypertension.Methods 114 elderly patients with hypertension were divided into 2 groups according to Hcy levels,normal-Hcy group(n = 61) with a level of Hcy≤15 μmol / L and highHcy group(n = 53) with a level of Hcy > 15 μmol / L.The levels of baPWV and ankle-brachial index(ABI) were assessed by an automatic oscillometric method.Fasting plasma glucose,creatinine,uric acid,triglyceride,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,hs-CRP and mean blood pressure were examined at the same time.Results The level of Hcy was significantly higher in the high-Hcy group(22.41 ± 8.61 μmol / L) than that in the normal-Hcy group(11.71 ± 1.88 μmol / L)(P<0.01).The level of baPWV was higher in the high-Hcy group(2150 ± 476 cm / s) than that in the normal-Hcy group(1561 ± 201 cm / s)(P<0.01).The level of creatinine was higher in the high-Hcy group than that in the normal-Hcy group(P<0.05).Multiple regression analysis showed that baPWV was independently predicted by Hcy level.Conclusions The elevated level of Hcy in elderly patients with hypertension is closely correlated with baPWV.