老年高血压患者血浆同型半胱氨酸的变化及意义

Plasma Homocysteine Levels in Elderly Hypertensive Patients

目的 测定老年高血压患者及正常人血浆同型半胱氨酸水平 ,评价血浆同型半胱氨酸水平在高血压发病中的意义。方法 收集 10 1例高血压患者 (收缩压大于 14 0mmHg ,舒张压大于 90mmHg)及 6 0例健康人血液标本 ,采用荧光标记免疫检测法测定血浆同型半胱氨酸水平 ;放射免疫检测法测定血浆维生素B12 及叶酸水平。结果 高血压患者血浆同型半胱氨酸主要分布在 8mmol/L以上 ,范围在 5 .72～ 15 .38mmol/L之间 ;健康人主要分布在 8mmol/L以下 ,范围在 4 .92～ 8.4 2mmol/L之间。高血压患者平均血浆同型半胱氨酸水平较健康人明显升高 (P <0 0 0 1) ,而平均血浆维生素B12 及叶酸水平比对照组均明显下降 (P <0 0 0 1)。对照组及病例组维生素B12 、叶酸与同型半胱氨酸水平均呈显著负相关 (P <0 0 1或P <0 0 0 1)。结论 同型半胱氨酸水平升高可能是原发性高血压的原因之一 ,机制可能为动脉壁的弹性纤维降解增加 。

Objective Plasma homocysteine levels in elderly hypertensive patients were determined using case control design, and the significance of plasma homocysteine levels in pathogenesis of hypertension was evaluated. Methods Cases were 101 adults ≥50 years with a systolic blood pressure of ≥140 mmHg and diastolic blood pressure ≥90 mmHg. The recruiting criteria for the sixty control subjects were resemblance with the hypertensives except SBP<140 mmHg and DBP<90 mmHg.\ Homocysteine levels were determined by fluoroimmuoassay, and Vitamin B\-\{12\} and folic acid levels were measured using solid phase NO Biol Assay Kit. Results The average homocysteine values for hypertension was >8 mmol/L(5.72 to 15.38 mmol/L),and the average value for control was <8 mmol/L( 4.92 to 8.42 mmol/L). The median homocysteine value for hypertensive patients were significantly higher than for control subjects ( P <0 001). The median Vitamin B\-\{12\} and folic acid levels were notably lower in hypensives than in control ( P <0 001). A negative correlation between the plasma concentration of Vitamin B\-\{12\}, folic acid and homocysteine has been shown ( P <0 01 or P <0 001) . Conclusion Elevated levels of homocysteine may be related to hypertension. The possible mechanism for this is through a degradation of elastin in the arterial wall, resulting in increased arterial stiffness.