高血压患者臂踝脉搏波传导速度、颈动脉内膜中膜厚度与同型半胱氨酸、D-二聚体的相关性

Relationship Between Brachial-ankle Pulse Wave Velocity,Carotid Intima-media Thickness and Homocysteine,D-dimer in Patients with Hypertension

目的研究原发性高血压(EH)患者臂踝脉搏波传导速度(ba PWV)、颈动脉内膜中膜厚度(c IMT)与同型半胱氨酸(Hcy)、D-二聚体的相关性。方法选择246例EH患者,测量ba PWV、c IMT,分别按两者数值分组,ba PWV<1700 cm/s为动脉僵硬度正常组、≥1700 cm/s为动脉僵硬度异常组;c IMT<0.9 mm为正常组、0.9≤c IMT<1.2 mm为增厚组、c IMT≥1.2 mm为斑块组。同时检测Hcy、D-二聚体及血生物化学指标水平。结果动脉僵硬度异常组Hcy、D-二聚体水平较动脉僵硬度正常组显著增高(P<0.05);c IMT正常组、增厚组、斑块组Hcy、D-二聚体水平也依次增高(P<0.05)。偏相关分析显示,在排除年龄、体重、血脂、血糖后,ba PWV与Hcy、D-二聚体呈正相关(r=0.18、r=0.32,P<0.05),c IMT与Hcy、D-二聚体呈正相关(r=0.56、r=0.27,P<0.05),ba PWV与c IMT也呈正相关(r=0.29,P<0.05)。结论 Hcy的增加和D-二聚体的升高与预示动脉病变的ba PWV、c IMT存在相关性。

Aim To study relevance of essential hypertension（ EH） patients with brachial-ankle pulse wave velocity（ ba PWV）,carotid intima-media thickness（ c IMT） and homocysteine（ Hcy）,D-dimer. Methods The study was performed on 246 essential hypertension patients. According to ba PWV they were divided into normal group（ ba PWV 1700 cm/s） and abnormal group（ ≥1700 cm/s）. According to c IMT they were divided into normal group（ cIMT〈0.9 mm）,thickening group（ 0. 9 ≤c IMT 1. 2 mm）,plaque group（ c IMT≥1. 2 mm）. And Hcy,D-dimer and blood biochemistry were detected. Results Hcy and D-dimer levels in abnormal arterial stiffness group were significantly increased compared with those in normal arterial stiffness group（ P〈0. 05）. Hcy and D-dimer levels in the normal c IMT group,the thickening group,the plaque group were gradually increased. Partial correlation analysis showed that after excluded age,weight,blood lipids and blood glucose,ba PWV was positively correlated with Hcy and D-dimer（ r = 0. 18,r= 0. 32,P〈0. 05）,c IMT was positively correlated with Hcy and D-dimer（ r = 0. 56,r = 0. 27,P〈0. 05）,Ba PWV was positively correlated with c IMT（ r = 0. 29,P〈0. 05）. Conclusion The increase of Hcy and D-dimer were correlated with c IMT and ba PWV which predicted artery disease.