高同型半胱氨酸血症对高血压患者血压变异性的影响

Effect of hyperhomocysteinemia on blood pressure variability in patients with hypertension

目的探讨高同型半胱氨酸血症(HHcy)对高血压患者血压变异性的影响。方法选取2018年1月至2020年1月本院收治的180例HHcy高血压患者作为研究对象,根据同型半胱氨酸(Hcy)水平分为重度升高组、中度升高组、轻度升高组,每组60例;另选取本院同期60例Hcy正常高血压患者作为对照组。4组均进行Hcy水平检测及血压监测,比较4组Hcy水平、血压变异性指标及轻度组与中度组血压控制效果。结果随着Hcy水平升高,患者血压变异性逐渐加重(P<0.05);重度升高组Hcy水平、24 h收缩变异性(24HSBV)、24 h舒张变异性(24HDBV)、日间收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)、日间舒张压变异性(dDBPV)、夜间舒张压变异性(nDBPV)均高于中度升高组、轻度升高组及对照组,且中度升高组高于轻度升高组及对照组,轻度升高组高于对照组,差异有统计学意义(P<0.05)。轻度升高组舒张压、收缩压均低于中度升高组,差异有统计学意义(P<0.05)。结论Hcy水平可在一定程度上反映高血压患者的血管损伤情况,其水平升高会显著增加患者的血压变异性。

Objective To investigate the effect of hyperhomocysteinemia(HHcy)on blood pressure variability in patients with hypertension.Methods 180 patients with hypertension and HHcy admitted to our hospital from January 2018 to January 2020 were selected as the study subjects,they were divided into the severe elevated group,the moderate elevated group and the mildly elevated group according to the level of homocysteine(Hcy),with 60 cases in each group,and another 60 hypertensive patients with normal Hcy during the same period in our hospital were selected as the control group.Hcy level and blood pressure were detected in all the four groups,Hcy level and blood pressure were detected in all the four groups.Results With the increase of Hcy level,the blood pressure variability was gradually aggravated(P<0.05).Hcy level,24-hour systolic blood variability(24HSBV),24-hour diastolic blood variability(24HDBV),diurnal systolic blood pressure variability(dSBPV),nocturnal systolic blood pressure variability(nSBPV),diurnal diastolic blood pressure variability(dDBPV),nighttime diastolic blood pressure variability(nDBPV)in the severely elevated group were higher than those in the moderately elevated group,the mildly elevated group and the control group,and moderately elevated group was higher than those in mildly elevated group and control group,and mildly elevated group was higher than control group,the differences were statistically significant(P<0.05).The diastolic blood pressure and systolic blood pressure in the mildly elevated group were lower than those in the moderately elevated group,and the difference was statistically significant(P<0.05).Conclusion The level of Hcy can reflect of patients with hypertension to certain extent,and the increase of Hcy level will significantly increase the blood pressure variability of patients.