老年单纯收缩期高血压患者脉压与同型半胱氨酸和颈动脉内膜厚度相关性研究

Correlation between pulse pressure and homocysteine,carotid artery intima-media thickness in senile patients with simple systolic hypertension

目的:研究老年单纯收缩期高血压患者的脉压与同型半胱氨酸、颈动脉内膜厚度的关系。方法:从我院2010年3月至2012年3月心内科收治的患者中,分别选取34例老年单纯收缩期高血压(ISH)患者作为A组,30例全期型高血压(SDH)患者作为B组,32例单纯舒张期高血压(IDH)患者作为C组,另选取30例健康体检者作为对照(D组),分别检测各组患者的脉压(PP)、血同型半胱氨酸(HCY)及颈动脉内膜厚度(IMT)。结果:A组患者的PP和血HCY水平分别为(83.53±8.07)mmHg、(27.54±4.16)mmol/L,均高于B组、C组、D组患者,且A组的平均颈动脉IMT为(1.86±0.27)mm,与D组相比较,差异有统计学意义(P<0.05)。ISH患者的脉压与血HCY及IMT呈正相关。A组的颈动脉粥样斑块和缺血性脑卒中发生率分别为91.2%、61.8%,明显高于B、C、D组患者,差异均有统计学意义(P<0.05)。结论:老年单纯收缩期高血压(ISH)患者的PP增大与血HCY水平升高和颈动脉IMT增加有关。PP和HCY是ISH患者动脉粥样硬化进程中的重要影响因子。

Objective： To study correlation between pulse pressure and homocysteine, carotid ar- tery intima-media thickness in senile patients with simple systolic hypertension. Methods： Thirty-four se- nile patients with simple systolic hypertension （ISH） that were admitted to our hospital during March 2010 and March 2012 were selected as group A, 30 eases of total period hypertension （ SDH ） patients were enrolled as group B, and 32 patients with isolated diastolic hypertension （ IDH ） as group C, another 30 healthy volunteers were selected as control group （group D）. Pulse pressure （PP）, serum homocys- teine （HCY） and carotid artery intima-media thickness （IMT） were detected in all the subjects. Results：PP and serum HCY levels were （83.53±4- 8.07） mmHg, （27.54 ±4. 16） mmol/L, respectively, both higher than those in group B, C and group D. The IMT of group A was （t. 86 ±0. 27） ram, significant different from that of group D （P〈0.05）. For ISH patients, PP was positively correlated with serum HCY and IMT. Incidence of atheromatous plaque in carotid artery and ischemic stroke was 91. 2%, 61.8% in group A, significantly higher than that of group B, C and group D （P〈O. 05）. Conclusion. In elderly ISH patients, increased PP is correlated with elevated serum HCY levels and carotid artery IMT. Bedsides, PP and HCY are important impact factors in the progression of atherosclerosis.