高血压患者血浆同型半胱氨酸水平与颈动脉粥样硬化的关系

Relationship between Plasma Total Homocysteine and Carotid Atherosclerosis in Hypertentive Patients

目的探讨高血压患者血浆总同型半胱氨酸(Hcy)水平和颈动脉内膜中层厚度(IMT),以及血浆总Hcy与颈动脉粥样硬化之间的关系。方法采用免疫酶标吸附法测定60例高血压患者、60例健康对照血浆总Hcy水平,采用彩色多普勒超声测定颈动脉IMT。结果高血压组血浆Hcy水平明显高于对照组(P<0.01),颈动脉IMT高于对照组(P<0.05),出现颈动脉增厚及斑块的比例高于对照组(P<0.05)。随着斑块严重程度的增加,血浆总Hcy水平呈增高趋势,并与颈动脉斑块的发生率呈正相关(r=0.341,P<0.05)。颈动脉IMT与年龄(r=0.41,P<0.01)、总胆固醇(r=0.28,P<0.05)、低密度脂蛋白胆固醇(r=0.37,P<0.05)、收缩压(r=0.35,P<0.01)呈正相关,与体重指数、三酰甘油、高密度脂蛋白胆固醇、空腹血糖、舒张压无相关。结论高血压患者血浆总Hcy及颈动脉IMT明显增高,两者呈正相关;血浆高Hcy、年龄、总胆固醇、低密度脂蛋白胆固醇、收缩压增高是颈动脉粥样硬化的重要危险因素。

Objective To investigate the level of plasma total homocysteine（Hcy）,the carotid intima-media thickness（IMT）and relationship of the plasma Hcy and carotid atherosclerosis in hypertensive patients.Methods Sixty patients with hypertension and sixty health controls were measured for carotid IMT and the level of plasma total Hcy.Results The level of plasma total Hcy and the carotid IMT in hypertensive patients increased significantly compared with that of the controls.The level of plasma total Hcy increased with the severity of the carotid plaque.The carotid IMT was correlated with age,cholesterol,low-density cholesterol,systolic blood pressure（P〈0.05 or P〈0.01）.Conclusion The average carotid IMT is correlated with the level of plasma Hcy in hypertensive patients;the level of plasma total Hcy,age,cholesterol,low-density cholesterol,systolic blood pressure are the important risk factors of carotid atherosclerosis.