社区H型高血压患者血压变异性与血同型半胱氨酸及尿酸的关系

Relationship between blood pressure variability and homocysteine,uric acid levels in type-H hypertensive patients

目的探讨社区H型高血压患者血压变异性与血同型半胱氨酸(homocysteine,Hcy)和尿酸(serum uric acid,SUA)的关系。方法收集2014年7月—2017年7月在杨浦区定海社区卫生服务中心诊断为H型高血压患者401例临床资料,按血压水平分为高血压Ⅰ级(n=65)、高血压Ⅱ级(n=109)、高血压Ⅲ级(n=227)。选取同期在定海社区卫生服务中心健康体检患者40例为对照组。所有患者及对照组皆检测Hcy、SUA水平,并通过24 h动态血压检测患者24 h、白昼及夜间收缩压标准差、舒张压标准差,计算相应的变异系数,比较Hcy、SUA与BPV相关性及不同血压水平组Hcy、SUA、BPV的变化。结果 Hcy与白昼收缩压及舒张压变异、24 h收缩压及舒张压变异呈正相关; SUA与白昼收缩压变异、夜间收缩压变异、24 h收缩压变异呈正相关;伴随高血压分级升高,Hcy、SUA、白昼收缩压变异逐渐增大。结论 Hcy、SUA、白昼收缩压变异是H型高血压患者独立危险因素,提示对于H型高血压患者,不仅需要关注患者血压水平,同时还需注意和重视H型高血压患者Hcy、SUA及BPV的管理。

Objective To explore the relationship between blood pressure variability （BPV） and serum homocysteine（Hcy）, uric acid（SUA） levels in type-H hypertensive patients.Methods Clinical data of 401 patients with type-H hypertension diagnosed in community health service center from July 2014 to July 2017 were collected, including 65 cases of grade I, 109 cases of grade Ⅱ and 227 cases of grade Ⅲ. Forty healthy subjects in the community were selected as control group. Serum Hcy and SUA levels were measured. The 24 h ambulatory blood pressure test was performed and the variation coefficient of blood pressure was calculated. The correlation of Hcy and SUA levels with BPV was analyzed.Results Hcy was positively correlated with day systolic pressure and diastolic blood pressure variation, 24 h systolic pressure and diastolic pressure variation. SUA was positively correlated with day systolic variation, nocturnal systolic pressure variation, and 24 h systolic blood pressure variation. With elevated hypertension, the variation of Hcy, SUA and day systolic blood pressure were gradually increased.Conclusion Hcy, SUA and the day systolic blood pressure variation are independent risk factors for patients with H-type hypertension. To better control blood pressure in H-type hypertensive patients, attention should be paid to the management of blood Hcy, SUA levels and BPV.