血浆HCY、hs-CRP水平与高血压病人颈动脉粥样硬化的相关性及其危险因素分析

CORRELATION BETWEEN PLASMA HCY AND hs-CRP LEVELS AND CAROTID ATHEROSCLEROSIS IN PATIENTS WITH HYPERTENSION AND ITS RISK FACTORS

目的:探讨血浆HCY、hs-CRP水平与高血压病人颈动脉粥样硬化的相关性及其危险因素分析。方法:110例高血压病人,按照高血压诊断标准进行分组分别为Ti、Tz、Ts组,观察Ti、Tz、Ts组颈动脉超声检查结果、总胆固醇、HCY、甘油三酯、hs-CRP水平;分析HCY、hs-CRP水平与颈动脉粥样硬化的关系,并做logistic回归分析。结果:超声检查Ts组20例出现斑块(指不稳定和稳定斑块),Tz组出现斑块有15例,Ti组出现斑块有12例,Tz、Ts组病人斑块检出率比Ti组低,Ti、Tz、Ts组间无显著差异(P>0.05)。Ti、Tz、Ts组病人血清TC、甘油三酯(TG)值无显著差异(P>0.05),Ti组HCY、hs-CRP水平最低,Tz组HCY、hs-CRP水平其次,Ts组出现最高HCY、hs-CRP值(9.86±4.32、13.84±1.21),Ti、Tz、Ts组间有显著差异(P<0.05)。与不稳定斑块组相比,无斑块组hsCRP、HCY值明显降低,稳定斑块组hs-CRP、HCY值高于无斑块组,且低于不稳定斑块组,不稳定斑块组hsCRP、HCY值为(26.45±10.21、34.54±11.62),无斑块组、稳定斑块组、不稳定斑块组间有显著差异(P<0.05)。由logistic回归分析发现,HCY、hs-CRP和颈动脉斑块、TC、TG均为影响高血压颈动脉粥样硬化的独立危险因素。结论:HCY及hs-CRP值增加,高血压病人颈动脉粥硬化加重,HCY及hs-CRP与高血压颈动脉粥样硬化为正相关关系,HCY、hs-CRP也是其独立危险因子。

Objective:To explore the correlation between serum HCY, hs-CRP and carotid atherosclerosis in patients with hypertension, and analyze the risk factors of the disease. Methods: 110 hypertensive patients were divided into Ti, Tz and Ts groups on the basis of blood pressure. The carotid artery ultrasonography results of Ti, Tz and Ts groups were observed. The levels of total cholesterol, HCY, triglyceride and hs-CRP were analyzed. The relationship between the levels of HCY, hs-CRP and carotid atherosclerosis was analyzed by grouping and loTistic regression analysis. Results: Ultrasound examination showed plaques in 20 cases(instability and stable plaque)in the Ts group, 15 cases in the Tz group, 12 cases in the Ti group, and plaque detection rate in the Tz and Ts groups compared with the Ti group. There was no significant difference between the Ti, Tz and Ts groups(P>0.05). There were no significant differences in serum TC and TG values between the Ti, Tz and Ts groups(P>0.05). The levels of HCY and hs-CRP were lowest in the Ti group, followed by the HCY and hsCRP levels in the Tz group, and the highest HCY and hs-CRP in the Ts group. Values(9.86±4.32, 13.84±1.21), there were significant differences between the Ti, Tz, and Ts groups(P<0.05). Compared with the unstable plaque group, the hsCRP and HCY values were significantly lower in the non-plaque group, and the hs-CRP and HCY values in the stable plaque group were higher than those in the non-plaque group and lower than the unstable plaque group. The hs-CRP and HCY values in the plaque group were(26.45±10.21, 34.54±11.62), and there were significant differences between the non-plaque group, the stable plaque group and the unstable plaque group(P<0.05). Logistic regression analysis showed that HCY, hsCRP and carotid plaques, TC and TG were independent risk factors for carotid atherosclerosis. Conclusion: The increase of HCY and hs-CRP may aggravate carotid atherosclerosis in hypertensive patients. Positive correlation between HCY and hsCRP and carotid atherosclerosis in hypertensive patients is also an independent risk factor.