老年高血压病患者血浆同型半胱氨酸与动脉粥样硬化的关系

Relationship between Horaocysteine and Atherosclerosis in Elderly Hypertensive Patients

目的:测定老年单纯高血病患者、高血压合并冠心病患者及正常老年人的血浆同型半胱氨酸(Homocysteine,HCY)水平及颈动脉(Carotid)、股动脉(Femoral Artery)粥样硬化程度,评价血浆HCY对老年高血压患者动脉粥样硬化(Atherosclerosis,AS)程度的影响。方法:选取28例健康老年人及73例老年高血压病患者,其中包括35例单纯高血压患者及38例合并冠心病(CAD)患者。取血标本用荧光标记免疫法测定HCY水平,同时用高频超声仪测量患者颈动脉内中膜厚度(IMT)及颈、股动脉的斑块(Plaque)。结果:老年高血压病患者的HCY水平及颈动脉IMT、斑块严重程度较健康老年人明显升高(P均<0.05),分析显示HCY水平与动脉粥样硬化程度正相关(r=0.37,P<0.05),独立于年龄、性别、吸烟、血脂等因素,另外高血压病患者HCY水平与是否患有冠心病独立正相关。结论:老年高血压患者的HCY水平升高是AS及冠心病的独立危险因素,其发病机制可能与内皮损伤,平滑肌增生有关。

Objective:.We detemined the Homocysteine (HCY) level in normal, Essential Hypertension(EH), EH with Coronary Artery Disease (CAD) elderly respectively. Besides, the carotid and the femoral artery were measured at the same patients. The aim of this study was to evaluate the value of the HCY on the extent of atherosclersis in elderly EH patients. Methods: The plasma HCY levels of all these elderly were determined with Fluoroimmunoassay method. These subjects are 28 normal old persons, 73 EH patients, including 35 EH patients without CAD, 38 EH with CAD patients. In addition, we also measured the carotid intimia-media thickness(IMT), carotid and femoral atherosclerotic plaques of the same patients. Results: Old patients with EH generally have the higher HCY level and more severe peripheral atherosclerosis than the normal elderly subjects (P<0.05). Furthermore, compared with single EH patients, EH with CAD patients have the similar result(F<0.05). Correlation analysis shows that HCY is closely related with atherosclerosis among elderly with EH. Conclusion: Blood HCY is the independent risk factor in CAD and peripheral atherosclerosis in elderly with EH. Its mechanism may be the damage of endothelium and stimulate the proliferation of the smooth muscles.