原发性高血压患者同型半胱氨酸水平与动脉病变及左心室肥厚关系的临床研究

Clinical Research for the Relationship Between Plasma Homocysteine and Atherosclerosis, Left Ventricular Hypertrophy in Patients With Essential Hypertension

目的:研究原发性高血压患者血浆同型半胱氨酸(Hcy)水平与动脉病变及左心室肥厚的关系。方法:将384例原发性高血压(高血压组)患者分为高血压1级者82例,高血压2级者196例,高血压3级者106例,另选79例健康体检人员为对照组,比较各组血浆同型半胱氨酸水平及颈动脉内中膜厚度及斑块情况,并根据超声心动图结果将高血压患者分为左心室肥厚者(258例)及无左心室肥厚者(126例),比较两者血浆同型半胱氨酸水平。结果:高血压组与对照组血浆同型半胱氨酸及颈动脉内中膜厚度组间比较差异均有统计学意义(P均<0.001),随高血压严重程度的加重,血浆同型半胱氨酸及颈动脉内中膜厚度均出现升高;高血压2级者、3级者的颈动脉斑块发生率高于1级者、对照组,差异均有统计学意义(P均<0.001);左心室肥厚的高血压患者血浆同型半胱氨酸水平高于无左心室肥厚的高血压患者,差异有统计学意义(P<0.001)。结论:同型半胱氨酸与原发性高血压的发病及进展关系密切,血浆同型半胱氨酸的水平可反映原发性高血压患者动脉病变及左心室肥厚病情的严重程度。

Objective： To study the plasma level of homocysteine （Hcy） and atherosclerosis, left ventricular hypertrophy in patients with essential hypertension （EH）. Methods： A total of 384 EH patients were divided into 3 groups： Grade I group, n=82, Grade II group, n=196 and Grade III group, n=106. There was a Control group containing 79 healthy subjects. Plasma levels of Hcy, carotid artery intima-media thickness and plaque condition were examined and compared among different groups. According to echocardiography, the EH patients were further divided into 2 groups： With left ventricular hypertrophy group, n=258 and Without left ventricular hypertrophy group, n=126. The plasma Hcy level was compared between 2 groups. Results： The plasma Hcy level and arotid artery intima-media thickness were different between Control group and EH patients, P〈0.001. With the increased severity of hypertension, the Hcy level and arotid artery intima-media thickness were elevated accordingly, and the carotid artery plaques in Grade II group and Grade III group were more than that in Grade I group, all P〈0.001. The Hcy level in With left ventricular hypertrophy group was higher than that in Without left ventricular hypertrophy group, P〈0.001. Conclusion： Plasma Hcy closely related to EH occurrence and development, Hcy level may reflect the severity of atherosclerosis and left ventricular hypertrophy in EH patients.