高同型半胱氨酸与高血压及不稳定型心绞痛的关系

Relationship among hypertension,unstable angina pectoris and high homocysteine level

目的：探讨高同型半胱氨酸（Hcy）与高龄高血压及不稳定型心绞痛（UAP）的关系。方法：选择于我院心内科诊治的208例高龄高血压伴有心绞痛患者,分为H型高血压组（102例）和一般高血压组（106例）,各组又分为UAP和稳定型心绞痛（SAP）两亚组,检测患者Hcy、血糖、总胆固醇（TC）、高密度脂蛋白胆固醇（HDLC）、甘油三酯（TG）水平;通过Gensini评分系统对患者冠状动脉病变程度进行评分。结果：与一般高血压组比较,H型高血压组UAP发病率（25.47%比46.08%）、Gensini评分[（30.2±15.6）分比（46.1±18.7）分]显著升高（P〈0.05）;H型高血压组中,UAP组Hcy水平明显高于SAP组[（22.8±7.2）μmol/L比（13.1±2.7）μmol/L],且UAP组高水平Hcy患者比例显著高于SAP组的（P均〈0.05）;一般高血压组患者中,与SAP组比较,UAP组Hcy[（7.1±1.5）μmol/L比（9.2±2.8）μmol/L]水平显著升高（P〈0.05）;Logisitic回归分析表明对于高龄UAP患者,Hcy是UAP的独立性危险因素（OR=1.9,95%CI：1.1-3.0,P=0.03）。结论：高龄H型高血压患者的UAP发病率显著高于一般高血压患者,Hcy是UAP的独立危险因素。

Objective： To explore the relationship among advancod aged hypertension, unstable angina pectoris （UAP） and high homocysteine （Hcy） level. Methods： A total of 208 advanced aged patients with hypertension andangina pectoris, who were diagnosed and treated in our department of cardiology, were divided into H-type hypertension group （n = 102） and general hypertension group （n = 106）. Each group was further divided into UAP subgroup and stable angina pectoris （SAP） subgroup. Levels of Hcy, blood glucose, total cholesterol （TC）, high densi- ty lipoprotein cholesterol （HDL-C） and triglyceride （TG） were measured; Gensini scoring system was used to score extent of coronary artery lesion in these patients. Results： Compared with general hypertension group, there were significant rise in incidence rate of UAP （25.47% vs. 46.08%） and Gensini score [ （30.2± 15.6） scores vs. （46. 1 ± 18. 7） scores in H-type hypertension group, P〈0.05; in H-type hypertension group, Hcy level in UAP subgroup was significantly higher than that of SAP subgroup [ （22.8±7. 2） μmol/L vs. （13.1 ± 2.7） μmol/L], and percent- age of paitents with high Hcy level in UAP group was significantly higher than that of SAP group, P〈0.05 all] in general hypertension group, compared with SAP group, there were significant rise in levels of Hcy[ （7. 1 ± 1.5） μmol/L vs. （9.2± 2.8） μmol/L] in UAP group, P〈0.05 ; Logistic regression analysis indicated that for advanced aged UAP patients, Hcy is an independent risk factor of UAP （OR = 1.9, 95% CI.. 1.1 -3.0, P = 0.03）. Conclusion： UAP incidence rate of H-type hypertension patients significantly rises than that of general hypertension pa- tients, Hcy is an independent risk factor of UAP.