CAJ | 학술논문

目的：探讨 H 型高血压与冠心病、脑梗死的关系。方法选取我院2012年10月-2013年9月收治的H 型高血压患者136例，根据冠状动脉造影、颅脑 MRI 检查结果分为4组：H 型高血压组62例，冠心病组32例，脑梗死组30例，冠心病并脑梗死组12例。测量各组患者血压，测定其血浆同型半胱氨酸水平、血脂、血糖等。结果单因素分析结果显示，各组血压、血糖及血浆总胆固醇、三酰甘油水平比较，差异均无统计学意义（P >0.05）；冠心病组、脑梗死组、冠心病并脑梗死组血浆同型半胱氨酸水平高于 H 型高血压组，冠心病并脑梗死组高于冠心病组、脑梗死组（P <0.05）。直线相关性分析结果显示，高血压患者血浆同型半胱氨酸水平与冠状动脉狭窄程度、脑梗死灶大小均呈正相关（r =0.780、0.802，P <0.05）。多因素 Logistic 回归分析结果显示，血浆同型半胱氨酸水平升高是冠心病〔OR =4.235，95% CI（1.386，16.852），P =0.014〕、脑梗死〔 OR =3.086，95% CI（1.003，13.206），P =0.047〕的独立危险因素。结论高血压患者血浆同型半胱氨酸水平升高是冠心病、脑梗死的独立危险因素，H 型高血压与冠心病、脑梗死密切相关。
목적：탐토 H 형고혈압여관심병、뇌경사적관계。방법선취아원2012년10월-2013년9월수치적H 형고혈압환자136례，근거관상동맥조영、로뇌 MRI 검사결과분위4조：H 형고혈압조62례，관심병조32례，뇌경사조30례，관심병병뇌경사조12례。측량각조환자혈압，측정기혈장동형반광안산수평、혈지、혈당등。결과단인소분석결과현시，각조혈압、혈당급혈장총담고순、삼선감유수평비교，차이균무통계학의의（P >0.05）；관심병조、뇌경사조、관심병병뇌경사조혈장동형반광안산수평고우 H 형고혈압조，관심병병뇌경사조고우관심병조、뇌경사조（P <0.05）。직선상관성분석결과현시，고혈압환자혈장동형반광안산수평여관상동맥협착정도、뇌경사조대소균정정상관（r =0.780、0.802，P <0.05）。다인소 Logistic 회귀분석결과현시，혈장동형반광안산수평승고시관심병〔OR =4.235，95% CI（1.386，16.852），P =0.014〕、뇌경사〔 OR =3.086，95% CI（1.003，13.206），P =0.047〕적독립위험인소。결론고혈압환자혈장동형반광안산수평승고시관심병、뇌경사적독립위험인소，H 형고혈압여관심병、뇌경사밀절상관。
Objective To study the correlation between H - type hypertension and coronary heart disease( CHD) and cerebral infarction(CI). Methods From October 2012 to September 2013,124 patients with H - type hypertension were selected in our hospital. According to the examination results of coronary arteriography and brain MRI,the above patients were divided into four groups:H - type hypertension group(n = 62),CHD group( n = 32),CI group( n = 30),CHD and CI group(n = 12). Blood pressure were measured,serum homocysteine level,blood liquid and blood glucose were detected in the four groups. Results Univariate analysis results showed that,there was no significant differences of blood pressure,blood glu-cose,serum levels of total cholesterol and triacylglycerol in the four groups( P > 0. 05);serum homocysteine level of CHD group,CI group,CHD and CI group was higher than that of H - type hypertension group,respectively,CHD and CI group was higher than that of CHD group,CI group,respectively(P < 0. 05). Linear correlation analysis showed that,serum homocys-teine level was positively correlated with degree of coronary artery stenosis,cerebral infarction size( r = 0. 780,0. 802,P <0. 05),respectively. Multivariate Logistic regression analysis results showed that,higher serum homocysteine level was a risk fac-tor of CHD〔OR = 4. 235,95% CI(1. 386,16. 852),P = 0. 014〕,CI〔 OR = 3. 086,95% CI(1. 003,13. 206),P =0. 047〕,respectively. Conclusion Higher serum homocysteine level was an independent risk factor of CHD or CI in patients with hypertension,H - type hypertension has certain correlation with CHD and CI.