H型高血压患者血管内皮功能变化及与血浆同型半胱氨酸水平的关系

The correlation between the changes of vascular endothelial function and plasma levels of homocysteine in patients with type H hypertension

目的探讨H型高血压患者血管内皮功能变化及与血浆同型半胱氨酸水平(Hcy)的关系。方法收治的原发性高血压患者120例,根据血浆Hcy水平分为观察组(82例H型高血压患者,Hcy≥10μmol/L)和对照组(38例单纯原发性高血压患者,Hcy<10μmol/L),选择同期体检的30例健康志愿者为空白组,检测3组血清一氧化氮(NO)、一氧化氮合成酶(NOS)、肱动脉血管内皮依赖性舒张功能(EDFMD)表达水平,Peaeson直线相关分析法研究原发性高血压患者血浆Hcy表达与血管内皮功能变化的相关性,Logistic回归分析法分析血管内皮功能指标(NO、NOS、EDFMD)的可能影响因素。结果高血压患者血浆Hcy较空白组显著较高,观察组H型高血患者Hcy较对照组单纯原发性高血压患者高,差异均有统计学意义(P<0.05);高血压患者血管内皮功能指标NO、NOS、EDFMD较空白组低,观察组上述指标较对照组显著较低,差异均有统计学意义(P<0.05);Peaeson直线相关分析显示高血压血浆hcy表达和血管内皮功能指标均呈显著负相关关系(r=-0.627、-0.608、-0.713,P<0.05);Logistic回归分析法显示血浆Hcy、收缩压(SBP)、舒张压(DBP)是血管内皮功能损害的影响因素(OR=1.162、1.427、3.584,P<0.05)。结论高血压患者血浆Hcy异常升高和伴有血管内皮功能损害,且在H型高血压患者中表现尤为明显;血浆Hcy过度表达是血管内皮功能指标异常的影响因素,二者表达呈高度负相关。

Objective To investigate the correlation between the changes of vascular endothelial function and plasma levels of homocysteine （Hcy） in patients with type H hypertension.Methods One hundred and twenty patients with essential hypertension who were admitted and treated in our hospital from January 2015 to May 2016 were enrolled in the study.According to Hcy levels,these patients were divided into observation group （82 patients with type H hypertension, Hcy≥10μmol/L） and control group （38 patients with simple primary hypertension, Hcy〈10μmol/L）,moreover, the 30 healthy volunteers were selected as blank control group.The levels of nitric oxide （NO）,nitric oxide synthase （NOS） and brachial artery endothelial dependent diastolic function （EDFMD） were detected,moreover, the correlation between the changes of vascular endothelial function and plasma levels of Hcy in patients with type H hypertension was analyzed by means of Peaeson linear correlation analysis,besides, the possible influencing factors of vascular endothelial function indexes including NO,NOS,EDFMD were analyzed by Logistic regression analysis.Results The levels of Hcy in patients with essential hypertension were significantly higher than those in blank control group,which in observation group were significantly higher than those in control group （P〈0.05）.The levels of NO,NOS and EDFMD in patients with essential hypertension were significantly lower than those in blank control group,which in observation group were significantly lower than those in control group （P〈0.05）.Peaeson linear correlation analysis showed that the plasma levels of Hcy in patients with essential hypertension were negatively correlated to vascular endothelial function indexes （r=0.627, 0.608, 0.713, respectively,P〈0.05）.Logistic regression analysis showed that plasma Hcy （SBP）,systolic blood pressure and diastolic blood pressure （DBP） were influencing factors of blood vessels endothelial function damage （Or=1.162,1.427,3.584,respectively,P〈0.05）.Conclusion The plasma levels of Hcy in patients with hypertension are abnormally increased,with vascular endothelial function damage,moreover,which is more obvious in patients with type H hypertension.The overexpression of Hcy is the influencing factors of vascular endothelial dysfunction,there is a close correlation between them.