H型高血压患者颈动脉弹性变化的相关性研究

Correlation study on change of carotid artery elasticity in H-hypertensive patients

目的探讨血浆同型半胱氨酸（Hcy）水平与H型高血压患者颈动脉弹性的相关性。方法选取2013年12月—2014年6月河北联合大学附属医院门诊及住院收治的53例H型高血压患者为病例组,按照Hcy水平升高的不同程度将其分为两组,Hcy15~30μmol/L（25例）为B组,Hcy 30~100μmol/L（28例）为C组,并选取同期的25例Hcy水平正常的高血压患者为对照组（A组）。检测所有受检者的颈总动脉内-中膜厚度（IMT）,并应用血管回声跟踪（ET）技术检测评价颈动脉弹性功能的各项指标：僵硬度（β）、压力-应变弹性系数（Ep）、顺应性（AC）、增大指数（AI）及单点脉搏波传导速度（PWVβ）,对各项检测结果进行统计学分析。结果 3组患者颈动脉弹性参数β、Ep、AC、PWVβ比较差异有统计学意义（P〈0.05）,且β、Ep、PWVβ：C组〉B组〉A组,AC：C组0.05）。3组IMT比较差异有统计学意义（P〈0.05）,且C组〉B组〉A组。Hcy水平与β、Ep、PWVβ均呈高度正相关,与IMT呈正相关,与AC呈负相关。结论 H型高血压患者颈动脉弹性减低;Hcy水平与H型高血压患者颈动脉弹性有一定的相关性,即Hcy水平越高,颈动脉弹性减低越明显。

Objective To explore the correlation between plasma homocysteine （Hey） levels and carotid ar- tery elasticity of H-hypertensive patients. Methods 53 H-hypertensive patients treated in Affiliated Hos- pital of Hebei United University from December 2013 to June 2014 were selected as the case group who were divided into two groups according to different levels of elevated Hcy levels： Hey 15--30 μmol/L （25 cases） as Group B; Hcy 30--100 μmol/L （28 patients） as Group C, and 25 H-hypertensive patients with normal Hey levels were picked out as the control group （group A）. The carotid artery intima-media thick- ness （IMT） of all subjects were detected. An ultrasonic echo-tracking （ET） method was used to evaluate common carotid artery elastic modulus, including stiffness parameter （13）, pressure-strain elastic modulus （Ep）, arterial compliance （AC）, augment index （AI） and one point pulse wave velocity （PWV/3）. Then all the tested results were statistically analyzed. Results The carotid artery elasticity parameters μ, EP, AC, PWVμ among the three groups were statistically significant （P〈0.05）. Of parameters 13, Ep, PWV13, Group C〉Group B〉Group A; Of AC, Group C〈Group B〈Group A; patameter AI had no statistical significance （P〉0.05）. The differences of IMT among the 3 groups were statistically significant with Group C〉Group B〉Group A. The levels of Hcy were positively correlated with the levels of Ep, PWVμ and μ, and positively correlated with IMT, negatively correlated with AC. Conclusion The carotid elastic- ity decreases in H-hypertensive patients, and there is a certain correlation between the levels of Hcy and carotid elasticity in H-hypertensive patients, namely, the higher the level of Hcy is, the more obviously the carotid elasticity decreases.