H型高血压患者血清Hcy、Cyst-C与血管内皮功能的相关性

Correlation between serum Hcy and Cyst-C and vascular endothelial function in patients with H-type hypertension

目的探讨H型高血压患者血清同型半胱氨酸(Hcy)、胱抑素C(Cyst-C)与血管内皮功能的相关性。方法选取2018年4月至2019年6月本院收治的180例H型高血压患者为研究对象。检测肱动脉血流介导的血管舒张功能(FMD),根据FMD将患者分为内皮功能正常组(FMD≧6.0%,n=78)和内皮功能受损组(FMD<6.0%,n=102),选择同时期健康体检者92例。检测患者空腹血糖、肌酐(Scr)、三酰甘油(TG)、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)、Hcy、Cyst-C,分析其与FMD的相关性。采用非条件Logistic回归分析内皮功能受损影响因素,用受试者工作曲线(ROC)和曲线下面积(AUC)评估血清Hcy、Cyst-C预测内皮功能受损的价值。结果内皮功能受损组患者年龄高于正常组和健康体检组(P<0.05);血清Hcy、Cyst-C水平比较,内皮功能受损组>内皮功能正常组>健康体检组(P<0.05);FMD与年龄、Hcy、Cyst-C呈负相关(r=-2.106、-3.125、-2.943,P<0.05);Logistic回归分析结果显示,年龄、Hcy、Cyst-C为内皮功能受损的独立危险因素(P<0.05);血清Hcy、Cyst-C预测内皮功能受损的截断值分别为≧15.52μmol/L、≧1.28 mg/L,AUC值分别为0.756、0.732。结论 H型高血压患者血清Hcy、Cyst-C与血管内皮功能呈负相关,是内皮功能受损的独立危险因素,可作为早期预测指标应用于临床。

Objective To explore the correlation between serum homocysteine(Hcy)and Cystatin C(Cyst-C)and vascular endothelial function in patients with H-type hypertension. Methods A total of 180 patients with H-type hypertension treated in our hospital from April 2018 to June 2019 were selected as the study subjects. The brachial artery blood flow-mediated dilatation(FMD)was detected,and patients were divided into normal endothelial function group(FMD≧6.0%,n=78)and impaired endothelial function group(FMD <6.0%,n=102)according to FMD,and another 92 cases of healthy examiners at the same time period were selected. The fasting blood glucose,creatinine(Scr),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),Hcy and Cyst-C were detected among the patients,and their correlation with FMD was analyzed. Unconditional Logistic regression analysis was used to analyze the influencing factors of endothelial function impairment,and the receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to evaluate the value of serum Hcy and Cyst-C in predicting endothelial function impairment. Results The age in impaired endothelial function group was higher than that in the normal group and heath examination group(P<0.05). Comparison of serum Hcy and Cyst-C showed impaired endothelial function group > normal endothelial function group > heath examination group. FMD was negatively correlated with age,Hcy and Cyst-C(r=-2.106,-3.125,-2.943,P<0.05). Logistic regression analysis showed that age,Hcy and Cyst-C were independent risk factors for endothelial function impairment(P<0.05). The cutoff values of serum Hcy and Cyst-C in predicting endothelial function impairment were≧15.52μmol/L and≧1.28 mg/L,and the AUC values were 0.756 and 0.732 respectively. Conclusion Serum Hcy and Cyst-C in patients with H-type hypertension are negatively correlated with vascular endothelial function. They are independent risk factors for endothelial function impairment and can be used as early predictive indicators for clinical application.