H型高血压患者血浆Hcy水平与高血压左室肥厚的关系

The correlation between homocysteine and hypertensive left ventricular hypertrophy in patients with H-type hypertension

目的研究H型高血压患者血浆同型半胱氨酸(homocysteine,Hcy)水平与高血压左心室肥厚(hypertension left ventricular hypertrophy,HLVH)的关系。方法选取符合纳入标准的H型高血压患者170例,根据血压水平分为高血压1级、2级及3级组;行心脏超声检查并计算左心室质量指数(left ventricular mass index,LVMI),根据左室肥厚程度分为HLVH组及非左室肥厚组(non-HLVH组)。检测受试者血浆Hcy、空腹血糖(fasting plasma glucose,FPG)、三酰甘油(trilycerides,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、尿酸(uric acid,UA)、血肌酐(serum creatinine,SCr)、血尿素氮(bloud urea nitrogen,BUN),分析血浆Hcy与LVMI的关系。结果 (1)按血压水平分3组,3组间年龄、FPG、TG、TC、LDL-C比较,差异无统计学意义(P> 0. 05),血浆Hcy、LVMI比较差异有统计学意义(P <0. 05),随血压水平升高而升高。(2)按LVMI分为两组,血浆Hcy差异有统计学意义(P <0. 05),HLVH组Hcy均高于non-HLVH组。(3) LVMI与Hcy、UA、SBP、DBP呈正相关(r=0. 620、0. 347、0. 785、0. 711,P <0. 05),行logistic分析示Hcy是HLVH增厚的独立危险因素(OR=1. 198,P <0. 05)。结论 H型高血压患者血浆Hcy与左室肥厚关系密切,是左室肥厚的独立危险因素。

Objective To investigate the correlation between plasma homocysteine level and left ventricular hy- pertrophy(HLVH)in patients with H-type hypertension.MethodsA total of170patients with H-type hypertension, who met the inclusion criteria,were selected.The patients were divided into Group1,2and3according to blood pressure levels.At the same time,the patients were divided into Group Left ventricular hypertrophy and Group Non-left ventricu- lar hypertrophy according to the degree of left ventricular hypertrophy.Plasma homocysteine,FPG,TG,TC,HDL-C, LDL-C,UA,SCr and BUN were assessed and the correlation between plasma homocysteine and LVMI was analyzed. ResultsAccording to the levels of blood pressure,there were no significant difference among the3groups in age,FPG, TG,TC,LDL-C,BUN or SCr(P>0.05),but there were significant differences in plasma homocysteine and LVMI (P<0.05),which were increased with the blood pressure.According to the LVMI,plasma homocysteine was significant- ly higher in HLVH group than Non-HLVH group(P<0.05).LVMI was positively correlated with homocysteine,UA, SBP and DBP(r=0.620,0.347,0.785and0.711,respectively,P<0.05).According to classified logistic regression analysis,homocysteine was an independent risk factor for HLVH(OR=1.198,P<0.05).ConclusionPlasma homo- cysteine in H-type hypertensive patients is correlated to ventricular hypertrophy,and is an independent risk factor for left ventricular hypertrophy.