不同分级高血压患者体内血清同型半胱氨酸的临床变化研究

Study on clinical changes in different classification of serum homocysteine in patients with hypertension

目的 探讨不同分级高血压患者体内血清同型半胱氨酸（Hcy）临床变化的临床意义及应用价值.方法 选取广东药学院附属第一医院及深圳市妇幼保健院2010年7月至2014年7月收治的529例原发性高血压患者,按照其血压水平分为1级组、2级组、3级组;并选取同期150名健康体检者纳入正常组.比较各组受试者血清胱抑素（Cystatin C,Cys C）、Hcy等指标,探讨其临床意义.结果 各组受试者血脂、血糖水平比较未见统计学差异（P＞0.05）.原发性高血压患者SUA、Cys C、Hcy水平显著高于正常组,且随其高血压分级上升,上述指标水平显著升高（P＜0.05）.1级组高Hcy血症阳性52例（28.1％）,2级组89例（46.4％）,3级组95例（62.5％）,对照组12例（8.0％）,高Hcy血症阳性率与受试者血清Hcy水平变化一致,组间比较差异有统计学意义（P＜0.05）.原发性高血压患者动态血压监测各项指标均显著高于正常组（P＜0.05）.1级组、2级组各项指标比较未见统计学差异（P＞0.05）,其各项指标标准差均显著低于3级组（P＜0.05）.结论 原发性高血压患者血清Hcy水平显著升高,且其血压水平、血压分级越高,血清Hcy水平升高更为明显,并预示着血压变异性（BPV）的变化.改善血清Hcy水平有助于患者血压的控制,降低继发心脑血管疾病风险.

Objective To observe the effect of the clinical changes of patients with different levels hyper- tensive of serum homocysteine（Hcy）, and to explore its clinical significance and application value. Methods 529 cases patients of hypertension were selected into this study. They were divided into 1 group, 2 grade group, 3 grade group according to their blood pressure levels. And 150 healthy persons were selected into the normal group. The differences between subjects of serum Cystatin C （Cys C）, Hcy and other indicators were compared. Results The subjects of blood lipid, blood glucose level showed no significant difference of each group（P〉0.05 ）. SUA, Cys C, Hcy levels of essential hypertension patients were significantly higher than those in the normal group. With the grade of hypertension increased, the index levels significantly increased （P〈0.05）. The 1 group of high serum Hcy was positive in 52 patients（28.1%）, grade 2 group was 89 cases（46.4%）, grade 3 group was 95 cases（62.5%）, and 12 cases （8%） of the control group. The positive rate in high Hcy subjects with serum Hcy levels consistent, comparative statistical difference existed between groups （P〈0.05）. The primary dynamic blood pressure monitoring indicators were significantly higher than those in the normal group （P〈0.05）. Indexes of Level 1 group and Level 2 group showed no significant difference （P〉0.05）, and the indexes of the standard deviation was significantly lower than the 3 level group （P〈0.05）. Conclusion The serum Hcy level in patients with primary hypertension in- creased significantly. With the higher level of blood pressure grades is, the level of serum Hcy will increase more, which indicates that the change of BPV. Control the level of serum Hey may eomtribute to control blood pressure in hypertension patients, and then may improve reducing the risk for subsequent cardiovascular and cerebrovascular diseases.