高血压急症与亚急症患者血清同型半胱氨酸水平与心脑血管动脉粥样硬化的相关性

Correlation between Serum Homocysteine Level and Cardio Cerebral Atherosclerosis in Hypertensive Emergency and Subacute Patients

【目的】探讨高血压急症及亚急症患者血清同型半胱氨酸(Hcy)水平与心脑血管动脉粥样硬化的相关性。【方法】检测79例本院收治的高血压急症与亚急症患者的血清Hcy水平,评估所有患者心脑血管动脉粥样硬化发生情况,其中发生心脑血管动脉粥样硬化的患者为观察组(n=48),未发生心脑血管动脉粥样硬化的患者为对照组(n=31)。比较两组的一般资料及血清Hcy水平,采用Logistic回归分析心脑血管动脉粥样硬化的影响因素;采用受试者工作特征(ROC)曲线评估血清Hcy水平对心脑血管动脉粥样硬化的预测价值。【结果】两组患者的性别、年龄、体重指数(BMI)、吸烟史、合并糖尿病和合并高脂血症的比例、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异均无统计学意义(P>0.05);观察组既往经皮冠状动脉介入手术(PCI)史占比、脑梗死史占比、肌酐(Cr)、尿素氮(BUN)、Gensini评分、Hcy水平均高于对照组(P<0.05);经Logistic回归分析,既往PCI史、脑梗死史、BUN、Gensini评分、Hcy均为高血压急症与亚急症患者心脑血管动脉粥样硬化的影响因素(P<0.05);经ROC分析显示,高血压急症与亚急症患者血清Hcy水平诊断心脑血管动脉粥样硬化的Cut-off值为8.76μmol/L,曲线下面积(AUC)为0.974,灵敏度为89.58%,特异度为96.77%。【结论】血清Hcy水平与高血压急症、亚急症患者心脑血管动脉粥样硬化密切相关,可为临床诊治提供依据。

【Objective】To investigate the correlation between serum homocysteine(Hcy)level and cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients.【Methods】Seventy-nine patients with hypertension emergency and sub emergency were selected were enrolled in the study The serum Hcy level was detected to evaluate the occurrence of cardio cerebral atherosclerosis.The patients with cardio cerebral atherosclerosis were the observation group(n=48),and the patients without cardio cerebral atherosclerosis were the control group(n=31).The general data and serum Hcy level of the two groups were compared,and the influencing factors of cardio cerebral atherosclerosis were analyzed by logistic regression;ROC was used to evaluate the predictive value of serum Hcy level in cardio cerebral atherosclerosis.【Results】There were no significant differences in terms of sex,age,BMI,smoking history,diabetes,hyperlipidemia,FPG,HbAlc,LDL-C,HDL-C between the two groups(P>0.05).The proportion of previous PCI history,cerebral infarction history,Cr,BUN,Gensini score and Hcy level in the observation group were higher than those in the control group(P<0.05).Logistic regression analysis showed that previous PCI history,cerebral infarction history,BUN,Gensini score and Hcy were the influencing factors of cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients(P<0.05).ROC analysis showed that the cut-off value of serum Hcy level in hypertensive emergency and sub emergency patients for the diagnosis of cardio cerebral atherosclerosis was 8.76μmol/L and the AUC value was 0.974,with the sensitivity of 89.58%and specificity of 96.77%.【Conclusion】There is a close correlation between serum Hcy level and cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients,which can provide useful reference for clinical diagnosis and treatment.