同型半胱氨酸水平与原发性高血压患者发生冠心病的关系研究

The relationship between the homocysteine level and coronary heart disease in patients with essential hypertension

目的探讨原发性高血压患者同型半胱氨酸（Hcy）水平与冠心病的关系.方法选择本院心内科住院治疗并诊断为原发性高血压的患者200 例,根据患者冠状动脉造影检查结果是否合并冠心病分为单纯高血压组（95 例）和合并冠心病组（105例）;测定和比较不同组血Hcy 值,通过logistic回归分析高血压患者Hcy 与冠心病的相关性.结果单纯高血压组Hcy 水平[（14.9±5.4）μmol/L]低于合并冠心病组患者[（20.2±7.4）μmol/L],差异有统计学意义（t=5.234,P〈0.01）;Hcy〉15mol/L 的患者有71 例（67.6%）,所占百分比高于≤15μmol/L 的患者34 例（32.4%）,差异有统计学意义（X^2=24.69,P〈0.05）;高Hcy 是原发性高血压发生冠心病的独立危险因素（OR=1.503,95%CI1.280～1.739,P〈0.05）.结论高Hcy原发性高血压患者冠心病风险增加.

Objective To explore the relationship between homocysteine （Hcy） level and coronary heart disease（CHD） in patients with essential hypertension. Methods A total of 200 inpatients with essential hypertension weredivided into no CHD group（n=95） and CHD group（n=105） based on the results of coronary angiography.Serum Hcywas measured and compared between the two groups. The logistic regression was analyzed to determine thecorrelation between serum Hcy and CHD. Results Serum Hcy was significantly higher in CHD group than no CHDgroup[（20.2±7.4）μmol/L vs. （14.9±5.4）μmol/L]（P〈0.01）.The percentage of CHD was 67.6% in patients with Hcy〉15μmol/L and 32.4% in patients with Hcy 〈15μmol/L. There was significant difference between them（P〈0.05）. Thelogistic regression analysis showed Hcy was an independent predictor of CHD in essential hypertension patients[OR=1.503, 95%CI （1.280,1.739）, P〈0.05]. Conclusion The risk of CHD increases in hypertensive patients withHcy increased.