老年高血压患者血浆同型半胱氨酸浓度与颈动脉内膜-中层厚度相关性的临床研究

The Relationship between Serum Homocysteine Concentration and Carotid Artery Intima-media Thickness in Elderly Patients with Hypertension

目的探讨老年高血压患者血浆同型半胱氨酸(Hcy)浓度与颈动脉内膜-中层厚度(IMT)的相关性及其临床意义。方法随机入选老年高血压住院患者70例(30例单纯高血压、40例高血压合并2型糖尿病)和32例健康对照者。采用循环酶法测定入选者血浆Hcy浓度及其颈动脉IMT。对Hcy浓度与颈动脉IMT进行直线相关分析。结果老年高血压各组血浆Hcy浓度高于对照组,且高血压合并糖尿病组血浆Hcy浓度高于单纯高血压组(P<0.01)。老年高血压各组左颈总动脉、右颈总动脉、左颈内动脉、右颈内动脉IMT高于对照组,高血压合并糖尿病组右颈内动脉IMT高于单纯高血压组(P<0.05)。相关分析显示:高血压合并糖尿病组血浆Hcy浓度与左颈总动脉、右颈总动脉IMT正相关(r=0.585、0.404,P<0.05)。结论血浆Hcy浓度在老年高血压组升高,且合并2型糖尿病组比单纯高血压组更高。颈动脉IMT在老年高血压组增厚,合并2型糖尿病组右颈内动脉IMT比单纯高血压组增厚更为显著。血浆Hcy浓度与颈动脉IMT正相关。

Objective To clarify the relationship and clinical significance between serum total homocysteine（Hcy） concentration and carotid artery intima-media thickness（IMT） in elderly patients with hypertension.Methods 70 elderly hospitalized hypertensive patients（30 cases of simple hypertension,40 cases of hypertension complicated by type 2 diabetes） and 32 healthy subjects were included in the study.Hcy concentrations and carotid artery IMT were measured by enzymatic cycling and analyzed by linear correlation analysis.Results Hcy concentration in elderly patients with hypertension was significantly higher than in controls.In addition,Hcy concentration in patients with hypertension complicated by type 2 diabetes was significantly higher than in simple hypertensive subjects（P 0.01）.IMT of the left common carotid artery,right common carotid artery,left internal carotid artery and right internal carotid artery in elderly patients with hypertension was significantly thicker than in controls and IMT of the right internal carotid artery in patients with hypertension complicated by type 2 diabetes was significantly thicker than in simple hypertensive subjects（P 0.05）.Linear correlation analysis showed that there was a significant positive relationship between serum total Hcy concentration and IMT of left common carotid artery,right common carotid artery in patients with hypertension complicated by type 2 diabetes（r =0.585,0.404,P 0.05）.Conclusion Serum total Hcy concentration is increased in elderly patients with hypertension and further increased in patients with hypertension complicated by type 2 diabetes.IMT of the carotid artery is increased in elderly patients with hypertension,and IMT of the right internal carotid artery is significantly thicker in patients with hypertension complicated by type 2 diabetes than in simple hypertensive subjects.There is a significant positive relationship between serum total Hcy concentration and IMT of carotid artery.