H型高血压与早发性脑梗死颈动脉内膜中层厚度及相关因素的研究

Association of H-type hypertension and Carotid Intima-Media Thickness and other relevant factors in patients with early ischaemic stroke

目的探讨早发性脑梗死患者中H型高血压和颈动脉内膜中层厚度及相关因素的关系。方法选取162例早发性脑梗死患者,根据血压、同型半胱氨酸(Hcy)水平分为H型高血压组(Hcy≥10μmol/L)、单纯高血压组(Hcy<10μmol/L)、非高血压组,比较三组患者的临床资料、生化指标及颈动脉内膜中层厚度(CIMT)。结果 H型高血压组与单纯高血压组收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、CIMT高于非高血压组,差异有统计学意义(P<0.05或0.01);H型高血压组CIMT高于单纯高血压组,差异有统计学意义;相关分析显示在H型高血压组Hcy与CIMT呈正相关,单纯高血压组则无相关;H型高血压组资料经Spearman相关分析显示,CIMT与年龄、TC、TG、LDL-C呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关;Logistic多元回归分析显示,HDL-C、Hcy是H型高血压组颈动脉内膜增厚的独立危险因素。结论 Hcy是H型高血压颈动脉内膜增厚的独立危险因素,控制"H型高血压"是早发性脑梗死防治的有效措施。

Objective To investigate the relationship of H-type hypertension and carotid intima media thick- ness（CIMT） and other relevant factors in patients with early ischaemic stroke. Methods According to their blood pressure and level of serum homocysteine （Hcy）, 162 patients with early ischaemic stroke were divided into three groups：the H-type hypertension group（ Hcy≥10 μmol/L）,the simple hypertension group（Hcy〈10μmol/L） and the non-hypertension group. The clinical features, biochemical indices and CIMT of patients in three groups were com- pared. Results In the H-type hypertension group and the simple hypertension group, the values of SBP,DBP,TC, LDL-C and CIMT were significantly higher than those in non-hypertension group（ P 〈0.05 oro. 01）. The CIMT val- ue of the H-tape hypertension group was significantly higher than that of the simple hypertension group. In thesimple hypertension group, there was no correlation between the H cy level and CIMT. However, there was a positive correla- tion between the Hcy level and CIMT in the H type group. Data of the H-type hypertension group was analyzed by Spearman, which indicated that CIMT was positively correlated to ages of patients, TC, TG, LDL C and negatively cor- related to HDL-C. Multiple Logistic regression analysis showed that HDL-C, Hcy were the independent risk factors thickening carotid intima of the H-type hypertension group. Conclusion Hcy is closely related to CIMT in hyperten- sive cerebral infarction,the effective control of Hcy and Blood pressure levels can reduce the incidence of early ischae- mic stroke.