高血压患者血清hs-CRP、Hcy及UA水平与颈动脉粥样硬化的相关性研究

Correlation research between serum hs-CRP, Hcy, UA and carotid atherosclerosis of patients with essential hypertension

目的探讨高血压患者血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、尿酸(UA)水平与颈动脉粥样硬化之间的相关性。方法选取2015年1月-2017年8月于蚌埠医学院第二附属医院住院的120例高血压患者作为研究对象,根据颈动脉超声检查颈动脉内膜-中层厚度(IMT)结果分为颈动脉粥样硬化组(60例,IMT>0.9 mm)与正常组(60例,IMT≤0.9 mm),将颈动脉粥样硬化组依据IMT检查结果分为内膜增厚组(30例,0.9 mm<IMT<1.2 mm)与内膜斑块组(30例,IMT≥1.2 mm),根据斑块稳定性将内膜斑块组分为内膜稳定斑块组(17例)与内膜不稳定斑块组(13例),分别检测上述各组患者血糖、TG、TC、HDL、LDL等常规指标以及血清hs-CRP、Hcy、UA水平。结果颈动脉粥样硬化组血糖、TG、TC、HDL及LDL水平与正常组比较差异均无统计学意义(均P>0.05)。颈动脉粥样硬化组hs-CRP、Hcy、UA水平均明显高于正常组(均P<0.05)。内膜增厚组hs-CRP、Hcy、UA水平均显著低于内膜斑块组(均P<0.05)。内膜稳定斑块组hs-CRP、Hcy、UA水平均明显低于内膜不稳定斑块组(均P<0.05)。结论血清hs-CRP、Hcy、UA水平可反映高血压患者颈动脉粥样硬化严重程度,血清hs-CRP、Hcy、UA水平越高,患者颈动脉粥样硬化越严重,三者对高血压颈动脉粥样硬化严重程度具有重要的预测价值。

Objective To investigate the correlation between serum hs-CRP, Hcy, UA and carotid atherosclerosis in patients with hypertension. Methods Total 120 patients with hypertensive in our hospital from January 2015 to August 2017 were selected as research object and divided into carotid atherosclerosis group(60 cases, IMT>0.9 mm) and normal group(60 cases, IMT≤0.9 mm) according to carotid artery intima-media thickness(IMT). The carotid atherosclerosis group was divided into intimal thickening group(30 cases, 0.9 mm <IMT < 1.2 mm and Intimal plaque group(30 cases, IMT≥1.2 mm) based on the IMT results. Intimal plaque group was divided into intimal stable plaque group(17 cases) and intimal unstable plaque group(13 cases). The blood sugar, TG, TC, HDL, LDL and hs-CRP, Hcy and UA levels of each group were detected. Results The blood glucose, TG, TC, HDL and LDL levels of carotid atherosclerosis group were not significantly different compared with those of normal group(P>0.05). The hs-CRP, Hcy, UA levels of carotid atherosclerosis group were significantly higher than those of normal group(P<0.05).The levels of hs-CRP, Hcy and UA in intimal thickening group were significantly lower than those of intimal plaque group(P<0.05). The hs-CRP, Hcy and UA levels of intimal stable plaque group were significantly lower than those of intimal unstable plaque group(P<0.05). Conclusion Serum hs-CRP, Hcy and UA levels could reflect the carotid atherosclerosis severity of patients with hypertension. The higher the serum hs-CRP, Hcy and UA levels, the severer carotid atherosclerosis in patients. The three indexes have predictive value on the hypertensive neck.