老年高血压患者血浆同型半胱氨酸水平与动脉损害的关系

Relationship between high homocysteine( Hcy) and arterial damage in the elderly patients with hypertension

目的探讨老年高血压患者高同型半胱氨酸(Hcy)与动脉损害的关系以及其中的致病机制。方法选择老年高血压患者312例,依据Hcy水平分为A组(Hcy≤10μmol/L),B组(10μmol/L<Hcy≤20μmol/L)和C组(Hcy>20μmol/L),所有患者行血浆Hcy、血压、低密度脂蛋白胆固醇(LDL-C)水平检查,颈动脉超声测量颈总动脉内膜中层厚度和斑块大小,肢体动脉硬化检测测量脉搏波传导速度(baPWV)和踝肱指数(ABI)。结果B组患者较A组脉压、颈动脉粥样硬化评分、baPWV均显著升高(P<0.05),2组ABI比较无显著差异。C组较A组脉压、颈动脉粥样硬化评分、baPWV、ABI均显著升高(P<0.05)。C组与B组比较脉压、颈动脉粥样硬化评分、baPWV、ABI均显著升高(P<0.05)。结论老年高血压患者动脉损害程度与Hcy水平相关。

Objective To investigate the relationship between high homocysteine（ Hcy） and arterial damage in the elderly patients with hypertension, and to discuss the pathogenic mechanism. Methods 312 cases of senile hypertension were selected. They were divided into three groups according to the Hcy level,group A with Hcy≤10 μmol /L,group B with 10 μmol /LHcy≤20 μmol /L and group C with Hcy20 μmol /L. The levels of plasma Hcy,blood pressure,low density lipoprotein cholesterol（ LDL-C）,intima-media thickness（ IMT）,plaques area,brachial ankle pulse wave velocity（ baPWV） and ankle brachial index（ ABI） of all patients were tested. Results Pulse pressure,carotid atherosclerotic scores,baPWV were significantly increased in group B than that in group A（ P〈0. 05）,but there were no significant difference in ABI. Pulse pressure,carotid atherosclerotic scores,baPWV,ABI of group C were significantly increased compared with patients of group A（ P 0. 05）. Compared with group B,pulse pressure,carotid atherosclerotic scores,baPWV,ABI in group C were significantly increased（ P〈0. 05）. Conclusions Hcy level is associated with arterial damage in elderly patients with hypertension.