CAJ | 학술논문

目的探讨H型高血压患者颈动脉结构改变及血浆同型半胱氨酸(homocysteine,Hcy)水平与颈动脉粥样硬化的相关性.方法将295例原发性高血压患者依据血浆Hcy水平分为H型高血压组和单纯型高血压组,对两组患者行颈动脉超声检查及血生化测定,分析两组间颈动脉超声参数及其与Hcy水平的相关性,并行颈动脉斑块形成危险因素分析.结果 H型高血压组和单纯型高血压组间斑块检出率、单发斑块检出率及≥2个斑块检出率差异有统计学意义(P＜0.05),内中膜厚度(intima-media thickness,IMT)[(1.00±0.16)mm对(0.89±0.18)mm]、斑块积分[(4.90±3.77)mm对(1.88±2.28)mm]差异均有统计学意义(P＜0.05).颈动脉IMT与Hcy呈正相关(r1=0.371,P=0.000),斑块积分与Hcy呈正相关(r2=0.696,P=0.000).Logistic回归显示年龄、IMT≥1.0 mm及Hcy≥10.0 μmol/L是颈动脉斑块形成的危险因素.结论 H型高血压患者颈动脉结构损害更严重,表明高Hcy血症与高血压具有协同作用,并且Hcy水平与颈动脉斑块形成及颈动脉硬化程度呈正相关,参与颈动脉粥样硬化的发展过程.
목적 탐토H형고혈압환자경동맥결구개변급혈장동형반광안산(homocysteine,Hcy)수평여경동맥죽양경화적상관성.방법 장295례원발성고혈압환자의거혈장Hcy수평분위H형고혈압조화단순형고혈압조,대량조환자행경동맥초성검사급혈생화측정,분석량조간경동맥초성삼수급기여Hcy수평적상관성,병행경동맥반괴형성위험인소분석.결과 H형고혈압조화단순형고혈압조간반괴검출솔、단발반괴검출솔급≥2개반괴검출솔차이유통계학의의(P＜0.05),내중막후도(intima-media thickness,IMT)[(1.00±0.16)mm대(0.89±0.18)mm]、반괴적분[(4.90±3.77)mm대(1.88±2.28)mm]차이균유통계학의의(P＜0.05).경동맥IMT여Hcy정정상관(r1=0.371,P=0.000),반괴적분여Hcy정정상관(r2=0.696,P=0.000).Logistic회귀현시년령、IMT≥1.0 mm급Hcy≥10.0 μmol/L시경동맥반괴형성적위험인소.결론 H형고혈압환자경동맥결구손해경엄중,표명고Hcy혈증여고혈압구유협동작용,병차Hcy수평여경동맥반괴형성급경동맥경화정도정정상관,삼여경동맥죽양경화적발전과정.
Objective To investigate the correlations of the structural change of carotid artery and the level of plasma homocysteine (Hcy) with the severity of carotid artery atherosclerosis in H type hypertension patients.Methods 295 essential hypertension patients were divided into two groups:H type hypertension group and simple hypertension group according to the concentration of plasma Hcy.All patients were underwent the carotid high-resolution ultrasonic examination and blood biochemical measurement to analyse the ultrasonic parameters and the correlation with the level of plasma Hcy,and to analyse the risk factors of carotid plaques formation.Results Comparison of H type hypertension group with simple hypertension group showed that:there were statistical differences between two groups in plaque detection rate,single plaque detection rate and ≥ 2 plaques detection rate (all P ＜ 0.05) ; there were statistical differences between two groups in intima-media thickness (IMT) with (1.00 ± 0.16)mm vs (0.89 ± 0.18)mm and in plaque score with (4.90 ± 3.77)mm vs (1.88-± 2.28)mm (all P ＜0.05).There were positive correlations of the level of plasma homocysteine with the carotid IMT (r1 =0.371,P =0.000),and with the carotid plaque score (r2 =0.696,P =0.000).The age,IMT≥1.0 mm and Hcy≥10.0μmol/L were risk factors of carotid atherosclerotic plaque formation by the binary Logistic regression analysis.Conclusions The more serious structural damage of carotid artery in H type hypertension compared with simple hypertension showed that there was a synergistic effect between the elevated plasma Hcy and hypertension,and there were positive correlations of the level of plasma Hcy with the plaque formation and the degree of carotid atherosclerosis,the level of plasma Hcy took part in the development process of carotid atherosclerosis.