原发性高血压患者血清同型半胱氨酸含量与颈动脉粥样硬化、左心室舒张功能的相关性

Correlation between serum homocysteine content and carotid atherosclerosis as well as left ventricular diastolic function in patients with essential hypertension

目的:研究原发性高血压患者血清同型半胱氨酸含量与颈动脉粥样硬化、左心室舒张功能的相关性。方法:选择106例合并存在高同型半胱氨酸血症的原发性高血压患者纳入H型高血压组(A组)、42例未合并存在高同型半胱氨酸血症的原发性高血压患者纳入非H型高血压组(B组)、60例健康体检者纳入对照组。行颈动脉超声和心脏超声,测定颈动脉粥样硬化指标和左心室舒张功能指标;采集血清并测定颈动脉粥样硬化指标和心肌重塑指标。结果:A组和B组患者颈动脉的IMT、β1、β2、Ep以及左心室的IVSd、LVPW、LVEDd、LVMI以及血清ox-LDL、MDA、MCP-1、VE-cadherin、TGFβ1、FGF23、PICP、ICTP、PIIINP含量均显著高于对照组,AC显著低于对照组;A组患者颈动脉的IMT、β1、β2、Ep以及左心室的IVSd、LVPW、LVEDd、LVMI以及血清ox-LDL、MDA、MCP-1、VE-cadherin、TGFβ1、FGF23、PICP、ICTP、PIIINP含量均显著高于B组,AC显著低于B组。结论:合并存在高同型半胱氨酸血症会促进原发性高血压患者颈动脉粥样硬化、氧化应激及炎症反应、左心室舒张功能减退、心肌重塑及纤维化的进程。

Objective：To study the correlation between serum homocysteine content and carotid atherosclerosis as well as left ventricular diastolic function in patients with essential hypertension.Methods：A total of 106 patients with essential hypertension and hyperhomocysteinemia were included in H-type hypertension group（group A）,42 patients with primary hypertension and without hyperhomocysteinemia were included in non-H-type hypertension group（group B）and 60 healthy subjects were included in control group.Carotid artery ultrasound and cardiac ultrasound were conducted to determine carotid atherosclerosis indexes and left ventricular diastolic function indexes;serum was collected to determine carotid atherosclerosis and myocardial remodeling indexes.Results：Carotid IMT,β1,β2and Ep,left ventricular IVSd,LVPW,LVEDd and LVMI as well as ox-LDL,MDA,MCP-1,VE-cadherin,TGFβ1,FGF23,PICP,ICTP and PIIINP content in serum of group A and group B were significantly higher than those of control group while the AC were significantly lower than that of control group;carotid IMT,β1,β2and Ep,left ventricular IVSd,LVPW,LVEDd and LVMI as well as ox-LDL,MDA,MCP-1,VE-cadherin,TGFβ1,FGF23,PICP,ICTP and PIIINP content in serum of group A were significantly higher than those of group B while the AC was significantly lower than that of group B.Conclusion：The combination of hyperhomocysteinemia will promote the carotid atherosclerosis,oxidative stress and inflammatory response,left ventricular diastolic hypofunction as well as myocardial remodeling and fibrosis process in patients with essential hypertension.