同型半胱氨酸水平与年龄因素在高血压合并焦虑状态中的作用探讨

The relation between serum homocysteine levels and age in patients of high blood pressure combined with anxiety state

目的 研究血清同型半胱氨酸（Hcy）水平及年龄因素在高血压患者合并焦虑状态之间的关系.方法 对164例近1周常规治疗血压仍不稳定的原发性高血压患者进行患者健康问卷抑郁量表（PHQ-9）和广泛性焦虑量表（GAD-7）抑郁焦虑状态测评,根据合并焦虑状态情况分为无焦虑组（28例）、轻中度焦虑组（81例）和重度焦虑组（55例）.分析患者的GAD-7水平,同时检测患者Hcy、LDL-C、HDL-C、高敏C反应蛋白（hs-CRP）和纤维蛋白原（FIB）,比较3组间的差别及与高血压合并焦虑状态程度的相关性.结果 无焦虑组、轻中度焦虑组、重度焦虑组的年龄分别为（58.1±2.4）、（58.2±2.0）、（60.6±2.3）岁,Hcy分别为（12.8±0.8）、（16.4±0.7）、（17.4±1.1） μmol/L,3组年龄及Hcy比较差异均有统计学意义（P＜0.05）.相关分析显示GAD-7评分与PHQ-9评分相关,相关系数为0.581 （P ＜0.01）；GAD-7评分与Hcy及年龄相关；与其他检验指标未显示相关性.多元回归分析显示PHQ-9、Hcy及年龄是影响高血压合并焦虑状态评分的重要因素.结论 Hcy水平和年龄因素与高血压合并焦虑状态程度具有相关性.

Objective To study the relation between serum homocysteine levels and age in patients of high blood pressure combined with anxiety state.Methods Totally 164 patients with primary hypertension were assessed in health questionnaire depression scale （PHQ-9） and generalized anxiety scale （GAD-7）.According to merge anxiety,all patients were divided into no anxiety group （28 cases）,mild-to-moderate anxiety group （81 cases） and severe anxiety group （55 cases）.GAD-7 levels of patients were analyzed.Homocysteine,low density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol （HDL-C）,high sensitive C-reactive protein and fibrinogen level of patients were detected; the differences among the three groups and the anxiety degree of correlation in combination with high blood pressure were compared.Results Mean age of no anxiety group,mild-to-moderate anxiety group and severe anxiety group was （58.1 ± 2.4）,（58.2 ± 2.0）,（60.6 ± 2.3） years respectively.Hcy was （12.8 ± 0.8）,（16.4 ± 0.7）,（17.4 ± 1.1） μmol/L respectively; there were significant differences on the age and Hcy among three groups （P 〈 0.05）.Analysis showed that GAD-7 score was associated with PHQ-9 scores ; correlation coefficient was 0.581 （P 〈 0.01）.Multiple regression analysis showed that PHQ-9,Hcy and age were the important factors that affected hypertension combined anxiety state score.Conclusion Hcy levels and age factors are associated with degree of hypertension combined anxiety state.