老年高血压患者血清同型半胱氨酸、超敏C反应蛋白及胱抑素C水平与颈动脉内膜中层厚度的相关性分析

Correlation between homocysteine,hypersensitive C-reactive protein,hystatin and intima-media thickness in elderly patients with hypertension

目的探讨老年高血压患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)水平与颈动脉内膜中层厚度(IMT)的相关性。方法选取2015年5月至2016年5月信阳市中心医院收治的126例老年高血压患者为研究对象,根据颈动脉粥样硬化程度将其分为IMT正常组(n=38)、IMT增厚组(n=43)和颈动脉斑块形成组(n=45),检测3组患者血清Hcy、hs-CRP、Cys C、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐、尿酸水平,并分析其与IMT的相关性。结果 IMT增厚组和颈动脉斑块形成组患者Hcy、hsCRP、Cys C、TC、LDL-C、肌酐、尿酸水平均显著高于IMT正常组(P<0.05);颈动脉斑块形成组患者Hcy、hs-CRP、Cys C、TC、LDL-C、肌酐、尿酸水平显著高于IMT增厚组(P<0.05);3组患者HDL-C水平比较差异无统计学意义(P>0.05)。Pearson相关性分析结果显示,IMT与血清Hcy、hs-CRP、Cys C、TC、LDL-C水平呈显著正相关(r=0.783、0.810、0.792、0.342、0.549,P<0.05),与HDL-C、肌酐、尿酸水平无显著相关性(r=0.125、0.213、0.198,P>0.05)。Logistic回归分析结果显示,Hcy、hs-CRP、Cys C是颈动脉内膜增厚的独立危险因素(P<0.05)。结论血清Hcy、hs-CRP、Cys C水平与老年高血压患者颈动脉粥样硬化程度关系密切,可作为颈动脉内膜增厚程度参考指标。

Objective To investigate the correlation between homocysteine （Hcy）,hypersensitive C-reactive protein （hs-CRP）,cystatin C（Cys C）and intima-media thickness（IMT） in elderly patients with hypertension.Methods One hundred and twenty-six elderly patients with hypertension in the Central Hospital of Xinyang City from May 2015 to May 2016 were selected as research subjects.The patients were divided into IMT normal group（n =38）,IMT thickening group（n =43）and carotid artery plaque group（n =45）according to the degree of carotid atherosclerosis.The levels of Hcy,hs-CRP,Cys,C,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,creatinine and uric acid of patients in the three groups were detected,and the correlation of them with IMT was analyzed.Results The levels of Hcy,hs-CRP,Cys C,TC,LDL-C,creatinine and uric acid of patients in IMT thickening group and carotid artery plaque group were significantly higher than those in IMT normal group （P 〈 0.05）;the levels of Hcy,hs-CRP,Cys C,TC,LDL-C,creatinine and uric acid of patients in carotid artery plaque group were significantly higher than those in IMT thickening group（P 〈0.05）;there were no statistic difference in the levels of HDL-C of patients among the three groups （P 〉 0.05）.Pearson correlation analysis showed that IMT was positively correlated with Hcy,hs-CRP,Cys C,TC,LDL-C （r =0.783,0.810,0.792,0.342,0.549;P 〈 0.05）;and the IMT was not correlated with HDL-C,creatinine and uric acid （r =0.125,0.213,0.198;P 〉 0.05）.Logistic regression analysis showed that Hcy,hs-CRP and Cys C were independent risk factors for carotid intima thickening（P 〈 0.05）.Conclusion The levels of serum Hcy,hs-CRP and Cys C are closely related to the degree of carotid atherosclerosis in elderly patients with hypertension,and these indexes can be used as a reference index of carotid artery intimal thickening.