H型高血压合并颈动脉粥样硬化患者血清同型半胱氨酸水平与斑块厚度的关系

Relationship between Serum Homocysteine Level and Plaque Thickness in Patients with H-type Hypertension Complicated with Carotid Atherosclerosis

目的:分析H型高血压合并颈动脉粥样硬化患者血清同型半胱氨酸水平与斑块厚度的关系。方法:选取2022年8月-2023年8月上海浦东新区花木社区卫生服务中心收治的58例原发性高血压合并颈动脉粥样硬化患者作为观察组,选取同期健康体检者20例作为对照组。两组均进行血清同型半胱氨酸检测,观察组进行颈动脉超声检查。根据血清同型半胱氨酸检测结果将观察组分为H型高血压组(同型半胱氨酸水平≥10μmol/L)、普通型高血压组(同型半胱氨酸水平<10μmol/L),比较三组同型半胱氨酸水平,比较观察组两个亚组颈动脉内中膜厚度,统计观察组颈动脉粥样硬化分级情况,比较不同颈动脉斑块分级患者同型半胱氨酸水平;分析同型半胱氨酸水平与斑块厚度的关系。结果:三组同型半胱氨酸水平比较,H型高血压组>普通型高血压组>对照组,差异有统计学意义(P<0.05)。H型高血压组颈动脉内中膜厚度大于普通型高血压组,差异有统计学意义(P<0.001)。不同颈动脉斑块分级患者同型半胱氨酸水平比较,3级>2级>1级>0级,差异有统计学意义(P<0.05)。H型高血压合并颈动脉粥样硬化患者同型半胱氨酸水平与斑块厚度呈正相关(r=0.342,P<0.05)。结论:H型高血压合并颈动脉粥样硬化患者血清同型半胱氨酸水平显著升高,该指标与动脉粥样硬化严重程度密切相关,对疾病早期诊断以及预后评估具有重要意义。

Objective:To analyze the relationship between serum homocysteine level and plaque thickness in patients with H-type hypertension complicated with carotid atherosclerosis.Methods:Fifty-eight patients with essential hypertension combined with carotid atherosclerosis admitted to Shanghai Pudong New Area Huamu Community Health Service Center from August 2022 to August 2023 were selected as the observation group.A total of twenty healthy subjects were selected as control group.Serum homocysteine was detected in both groups.The observation group underwent arteriostatic ultrasonography.According to the results of serum homocysteine detection,the observation group was divided into H-type hypertension group(homocysteine level≥10μmol/L)and ordinary hypertension group(homocysteine level<10μmol/L).The homocysteine level of the three groups was compared,the carotid intima-media thickness of the two subgroups of the observation group was compared,and the carotid atherosclerosis grade of the observation group was statistically analyzed.The homocysteine levels in patients with different carotid plaque grades were compared.The relationship between homocysteine level and plaque thickness was analyzed.Results:The homocysteine level of the three groups was compared,H-type hypertension group>ordinary hypertension group>control group,the difference was statistically significant(P<0.05);the thickness of carotid intima-media in H-type hypertension group was higher than that in ordinary hypertension group,and the difference was statistically significant(P<0.001);the homocysteine level of patients with different carotid plaque grades was compared,grade 3>Grade 2>Grade 1>grade 0,and the difference was statistically significant(P<0.05);homocysteine level was positively correlated with plaque thickness in patients with H-type hypertension complicated with carotid atherosclerosis(r=0.342,P<0.05).Conclusion:Serum homocysteine level is significantly increased in patients with H-type hypertension complicated with carotid atherosclerosis,which is closely related to the severity of atherosclerosis and has important significance for early diagnosis and prognosis assessment of the disease.