血浆HCY浓度水平与原发性高血压中医证型、血压分级及病程相关性研究

Study on the Relationships between Concentration of Plasma Homocysteine and TCM Syndrome Types and Level of Blood Pressure and Course of Disease in Inpatients with Essential Hypertension

目的:探讨原发性高血压患者血浆HCY浓度水平与中医证型、血压分级及病程的相关性。方法:采用酶法测定入选的662例原发性高血压住院患者血浆HCY浓度水平,依据《中药新药临床研究指导原则》中高血压中医证型分型标准将高血压分为四型:肝火亢盛证、阴虚阳亢证、痰湿壅盛证、阴阳两虚证,依据2003年世界卫生组织(WHO)血压分级标准将高血压分为1、2、3级,病程按1年、1<Y<10年、≥10年、≥20年、≥30年分为五个年龄段,采用SPSS14.0软件进行数据分析。结果:①血浆HCY水平在四个中医证型组中差别有显著统计学意义(P<0.01),其浓度水平依次为:痰湿壅盛证>阴阳两虚证>阴虚阳亢证>肝火亢盛证(P<0.01)。②血浆HCY浓度水平在三个血压组中差别亦有显著统计学意义(P<0.01),其浓度水平依次为:3级组>2级组>1级组(P<0.05)。③血浆HCY浓度水平在五个病程组中差别无统计学意义(P>0.05)。结论:①血浆HCY浓度水平与高血压中医证型有一定的相关性,可将其作为高血压中医证型分型的客观指标之一。②血浆HCY是高血压的独立危险因子,其浓度水平与血压分级呈正相关关系,可将其作为评估高血压病情严重程度和临床用药的参考指标。

Objective：To study the relationships between plasma homocysteine （HCY）and TCM syndrome types and level of blood pressure and course of disease among inpatients with essential hypertension（EH）. Methods：Plasma HCY of 662 cases were detected witll enzymatic method. These patients were categorized into four groups according to Guidance Priciple of Clinical Study on New Drug of TCM ： hyperactivity of liver-fire,hyperactivity of yang due to yin deficiency, excessive damp-phlegm and deficiency of both yin and yang. And they were categorized into three groups aceoding the standard of the World Health Organization（WHO） in 2003. Also,these patients were categorized into five groups according to course of disease： 1 year, 1 year 〈 Y 〈 10 years, 10 years ,20 years ,30 years. All statistical data was analyzed with SPSS software version 14.0. Results：l. The concentration of plasma HCY was statistically different in four TCM syndrome groups （P 〈 0. 01 ） ,it was higher in excessive damp-phlegm group than that of other three groups （ P 〈 0. 01 ）. 2. The concentration of plasma HCY was statistically different in three blood pressure level groups （ P 〈 0. 01 ） , plasma HCY concentrations in blood pressure level groups were as follows ：3 group 〉 2 group 〉 1 group （ P 〈 0. 01 ）. 3. There was no statistically difference between plasma HCY and course of disease（ P 〉 0. 05 ）. Conclusion ： I. The concen- tration of plasma HCY was correlated with TCM syndrome tapes, it may serve as a sensitive diagnosis indicator for TCM syndrome tapes. 2. The concentration of plasma HCY was one of independent risk factors of EH,it was positive correlated with level of blood pressure and can be used as a strong predictor for evluating the severity of hypertension.