原发性高血压患者血清25羟基维生素D、同型半胱氨酸及载脂蛋白B/A1变化的价值研究

Value of serum 25 hydroxy vitamin D,homocysteine and apolipoprotein B/A1 in patients with essential hypertension

目的探讨原发性高血压患者血清25羟基维生素D[25(OH)D]、同型半胱氨酸(Hcy)及载脂蛋白B/A1变化的价值。方法选自该院于2016年5月至2017年5月期间收治的原发性高血压患者191例作为观察组,按照高血压分级不同分为高血压1级组54例,高血压2级组78例,高血压3级组59例。另选自该院同期健康体检者54例作为对照组。比较各组血清25(OH)D、Hcy、载脂蛋白B/A1含量变化,以及25(OH)D、Hcy、载脂蛋白B/A1联合诊断灵敏度和特异度。结果观察组血清25(OH)D低于对照组,而Hcy和载脂蛋白B/A1水平高于对照组,差异均有统计学意义(P<0.05)。高血压3级组血清25(OH)D水平低于高血压1级组和高血压2级组,而Hcy和载脂蛋白B/A1水平高于高血压1级组和高血压2级组,差异均有统计学意义(P<0.05);高血压2级组血清25(OH)D水平低于高血压1级组,而Hcy和载脂蛋白B/A1水平高于高血压1级组,差异均有统计学意义(P<0.05)。25(OH)D、Hcy、载脂蛋白B/A1联合诊断灵敏度和特异度均高于25(OH)D、Hcy、载脂蛋白B/A1单项诊断灵敏度和特异度。结论原发性高血压患者血清25(OH)D降低,而Hcy和载脂蛋白B/A1升高,且25(OH)D、Hcy、载脂蛋白B/A1联合诊断灵敏度和特异度高。

Objective To investigate the value of serum 25 hydroxy vitamin D [25（OH）D],homocysteine（Hcy）and apolipoprotein B/A1 in patients with essential hypertension.Methods Totally 191 cases of essential hypertension admitted in the hospital from May 2016 to May 2017 were selected as observation group,and were divided into hypertension grade 1 group（54 cases）,hypertension grade 2 group（78 cases）,hypertension grade 3 group（59 cases）in accordance with the classification of hypertension.54 healthy people who underwent healthy assessment during the same period were selected as the control group.The changes of serum 25（OH）D,Hcy and apolipoprotein B/A1,and the sensitivity and the specificity of combined detection of 25（OH）D,Hcy and apolipoprotein B/A1 were compared.Results The serum 25（OH）D level in the observation group was lower than that in the control group,while the levels of Hcy and apolipoprotein B/A1 were higher than those in the control group,and the differences were statistically significant（P〈0.05）.The level of serum 25（OH）（OH）D in hypertension grade 3 group was lower than those in hypertension grade 2 group and hypertension grade 1 group,but the levels of Hcy and apolipoprotein B/A1 were higher than those in hypertension grade 2 group and hypertension grade 1 group,and the differencs were statistically significant（P〈0.05）;the level of serum 25（OH）D in hypertension grade 2 group was lower than that in hypertension grade1 group,but the levels of Hcy and apolipoprotein B/A1 were higher than those in hypertension grade 1 group,and the difference was statistically significant（P〈0.05）.The sensitivity and the specificity of combined detection of 25（OH）D,Hcy and apolipoprotein B/A1 were higher than those of single detection of 25（OH）D,Hcy and apolipoprotein B/A1.Conclusion Serum 25（OH）D level decreased in patients with essential hypertension,while Hcy and apolipoprotein B/A1 levels increased,and the combined detection of 25（OH）D,Hcy and apolipoprotein B/A1 had high sensitivity and specificity in diagnosis.