高同型半胱氨酸血症患者炎性反应血管内皮功能脉搏波速度的表达

To observe the inflammatory reaction,Vascular endothelial function and Brachial ankle pulse wave velocity in patients with hyperhomocystinemia

目的观察高同型半胱氨酸(Hcy)血症患者炎性反应、血管内皮功能、脉搏波速度的表达。方法选取2012年6月至2013年3月在该院体检中心体检的人群,无高血压、冠心病、糖尿病、脑梗死、肝肾功能不全等病史,依据Hcy水平分为A、B、C、D 4组,A组(Hcy<10μmol/L)、B组(10μmol/L≤Hcy<15μmol/L)、C组(15μmol/L≤Hcy<20μmol/L)、D组(Hcy≥20μmol/L),对入组人群行超敏C反应蛋白(hs-CRP)、血流介导的血管舒张反应(FMD)、硝酸甘油介导的血管舒张反应(NMD)、踝臂脉搏波速度(ba-PWV)检测。结果高Hcy各组hsCRP、ba-PWV均高于Hcy正常组,FMD、NMD低于Hcy正常组,且C、D组与Hcy正常组比较差异有统计学意义(P<0.05),D组与B组比较差异有统计学意义(P<0.05)。对Hcy与ba-PWV进行相关分析,显示二者呈正相关(r=0.467,P<0.05),Hcy与hs-CRP差异无统计学意义(P>0.05)。结论高Hcy组患者炎性反应、动脉僵硬度较明显,血管内皮功能较差,且这种变化随着Hcy水平的升高而更加明显。

Objective To observe the inflammatory reaction,Vascular endothelial function and brachial ankle pulse wave velocity （ba-PWV） in patients with hyperhomocystinemia. Methods 120 patients from our hospital＇s medical examination center from 2012.6 to 2013.3 without hypertension, coronary heart disease, diabetes, cerebral in- farction,liver and kidney dysfunction history were chosen. On the basis of homocysteine level, all the patients were di vided into group A （Hcy〈10 μmol/L） ,group B （10 μmol/L≤ Hcy〈15μmol/L） ,group C （15 μmol/L ≤Hcy〈20 μmol/L） ,and group D（ Hcy^20μmol/L）. The hs-CRP, flow-mediated dilatation （FMD）, nitroglycerin-mediated dil- atation （NMD） ,and ba-PWV were measured. Results To compare with group A,there were higher levels of hs-CRP and ba-PWV and lower levels of FMD and NMD in group B, group C and group D, there were statistically significant between group C,D and group A （P〈0.05） ,and there was significant difference between group D and group B （P〈 0.05）. Hcy had the positive relationship with ba-PWV （r= 0. 467 ,P〈0.05）, and there was no significant correlation between Hcy and hs-CRP（P〉0.05）. Conclusion Patients with hyperhomocystinemia have serious inflammatory re- action,arterial stiffness and worse vascular endothelial function than the patients with normal homocysteine,and the change was obvious with elevated homocysteine levels.