老年原发性高血压合并糖尿病患者中医证型 血压分级 病程与血浆 Hs-CRP HCY相关性研究

Study on the Relationships between Different TCM Syndrome Types and Level of Blood Pressure and Course of Disease with Changes of Blood Plasma Hs-CRP and HCY in Senile Essential Hypertension Patients with Type 2 Diabetes mellitus

目的:探讨老年原发性高血压合并糖尿病患者中医证型、血压分级、病程与血浆Hs-CRP、HCY的相关性。方法:148例老年原发性高血压合并糖尿病患者辨证为4型:肝火亢盛证、阴虚阳亢证、痰湿壅盛证、阴阳两虚证,血压分为1、2、3级,病程按<10年、10年、20年、30年分为4组,测定患者血浆Hs-CRP、HCY水平,并按证型、血压分级、病程分别统计,数据采用SPSS 14.0软件分析。结果:4个证型组中血浆Hs-CRP水平差别有统计学意义(P<0.05),肝火亢盛证组水平最高,与阴虚阳亢证、痰湿壅盛证、阴阳两虚证组比较差别有统计学意义(P<0.05),而阴虚阳亢证、痰湿壅盛证、阴阳两虚证3组差别无统计学意义(P>0.05)。血浆HCY水平在4个证型组中差别无统计学意义(P>0.05)。血浆Hs-CRP、HCY水平在血压组中为:3级组>2级组>1级组,3级组血浆Hs-CRP、HCY水平明显高于1级、2级组,差别有显著统计学意义(P<0.001),而1级、2级组差别无统计学意义(P>0.05)。病程组中血浆Hs-CRP、HCY水平差别无统计学意义(P>0.05)。结论:①血浆Hs-CRP水平可作为老年高血压合并糖尿病患者肝火亢盛证的辨证敏感指标。②Hs-CRP、HCY是高血压病的重要危险因子,血浆浓度水平越高,血压严重程度越重。③病程与血浆Hs-CRP、HCY水平之间无确切意义。

Objective：To study the relationships between the different TCM syndrome types,level of blood pressure,course of disease with the changes of blood plasma high sensitivity C-reactive protein（Hs-CRP） and homocysteine（HCY） in senile essential hypertension patients with type 2 diabetes mellitus.Methods：A total of 148 cases were divided into four TCM syndrome tapes： hyperactivity of liver-fire,hyperactivity of yang due to yin deficiency,excessive damp-phlegm,deficiency of both yin and yang.Blood pressure was divided into 1,2,3-level,course of disease according to10,10,20,30 years was divided into four groups.Blood plasma Hs-CRP was detected with immunoassay method and HCY was detected with enzymatic method.All data were analyzed with SPSS software version 14.0.Results：The level of Hs-CRP was statistically significant different in four TCM syndrome tape groups（P0.05）,the level of Hs-CRP in the hyperactivity of liver-fire group was significantly higher than that in other three groups（P0.05）,the differences among the three groups were no statistical significance（P0.05）.Plasma HCY levels in four TCM syndromes tape groups were no significant（P0.05）.Blood plasma Hs-CRP,HCY concentration levels in blood pressure groups were as follows ：3 grouP2 grouP1 group,plasma Hs-CRP and HCY concentration levels of 3 group were significantly higher than that of 1 and 2 group in these patients（P0.001）,while there were no significant differences in 1 and 2 group（P0.05）.Hs-CRP,HCY concentration levels were no significant differences in four course of disease groups（P0.05）.Conclusion：①The level of plasma Hs-CRP may serve as a sensitive indicator for TCM syndrome tapes diagnosis.②The increased concentrations of plasma Hs-CRP and HCY were closely correlated with increased level of blood pressure in these patients,which may act as the predictor risk factors for these patients.③The relationships were not found between Hs-CRP and HCY plasma concentration with course of disease.