CAJ | 학술논문

目的：探讨H型高血压患者血清同型半胱氨酸（Hcy）、胱抑素C(Cyst-C)、尿酸(UA)水平与颈动脉粥样硬化程度的关系。方法收集符合入选标准的132例H型高血压患者，应用彩色多普勒超声检查仪测定颈动脉内膜中层厚度(cIMT)，根据颈动脉粥样硬化的程度分为cIMT正常组40例，cIMT增厚组43例，颈动脉斑块形成组49例。检测并比较3组的血清Hcy、Cyst-C、UA、血糖、血脂、尿素氮、肌酐（Scr)水平，分析其与颈动脉cIMT的关系；Logistic回归分析影响颈动脉粥样硬化的因素。结果3组间血糖、尿素氮、Scr、三酰甘油（TG）、胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）水平差异无统计学意义，高密度脂蛋白胆固醇（HDL-c）水平颈动脉斑块形成组＜cIMT增厚组＜cIMT正常组，Cyst-C和UA均是颈动脉斑块形成组＞cIMT增厚组＞cIMT正常组，颈动脉斑块形成组的Hcy高于于cIMT正常组和cIMT增厚组（均P＜0.05）；cIMT与Hcy、Cyst-C、UA呈正相关（r分别0.26、0.30、0.23，P<0.05），与HDL-c呈负相关（r=-0.38, P<0.05)；Logistic回归分析示Hcy、Cyst-C、UA是cIMT的独立危险因素。结论 H型高血压患者血清Hcy、Cyst-C、UA水平是cIMT的独立危险因素，可作为颈动脉粥样硬化的早期预测指标。
목적：탐토H형고혈압환자혈청동형반광안산（Hcy）、광억소C(Cyst-C)、뇨산(UA)수평여경동맥죽양경화정도적관계。방법수집부합입선표준적132례H형고혈압환자，응용채색다보륵초성검사의측정경동맥내막중층후도(cIMT)，근거경동맥죽양경화적정도분위cIMT정상조40례，cIMT증후조43례，경동맥반괴형성조49례。검측병비교3조적혈청Hcy、Cyst-C、UA、혈당、혈지、뇨소담、기항（Scr)수평，분석기여경동맥cIMT적관계；Logistic회귀분석영향경동맥죽양경화적인소。결과3조간혈당、뇨소담、Scr、삼선감유（TG）、담고순（TC）、저밀도지단백담고순（LDL-c）수평차이무통계학의의，고밀도지단백담고순（HDL-c）수평경동맥반괴형성조＜cIMT증후조＜cIMT정상조，Cyst-C화UA균시경동맥반괴형성조＞cIMT증후조＞cIMT정상조，경동맥반괴형성조적Hcy고우우cIMT정상조화cIMT증후조（균P＜0.05）；cIMT여Hcy、Cyst-C、UA정정상관（r분별0.26、0.30、0.23，P<0.05），여HDL-c정부상관（r=-0.38, P<0.05)；Logistic회귀분석시Hcy、Cyst-C、UA시cIMT적독립위험인소。결론 H형고혈압환자혈청Hcy、Cyst-C、UA수평시cIMT적독립위험인소，가작위경동맥죽양경화적조기예측지표。
Objective To investigate the relationship of serum levels of homocysteine, cystain C and uric acid with ca?rotid atherosclerosis in H-type hypertension patients. Methods A total of 132 H-type hypertension patients were collected to be studied. Their carotid intima-media thickness (IMT) was measured by Doppler ultrasonography. And according to the result of carotid artery atherosclerosis, all patients were divided into normal cIMT group (n=40),thickened cIMT group (n=43) and plague formation group (n=49). Their serum Hcy, Cyst-C, UA, blood glucose, blood lipid, blood urea nitrogen and se?rum creatinine were compared among three group and their relationship with cIMT were analyzed. Logistic regression was used to screen risk factors for carotid atherosclerosis. Results There was no significant difference in serum levels of blood glucose,blood urea nitrogen, creatinine, serum creatinine (Scr), triglyceride (TG), total cholesterol (TC), low density lipppro?tein cholesterol (LDL-c) among these three groups (P>0.05). The level of high-density lipoprotein (HDL-c) in thickened cIMT group was higher than that in plague formation group, and lower than normal cIMT group, while both serum levels of Cyst-c and UA were lower in thickened cIMT group than those in plague formation group but higher than those in normal cIMT group (P<0.05). In addition, serum level of Hcy in normal cIMT group was higher than that in thickened cIMT group and plague formation group. The cIMT grade was positively correlated with serum levels of Hcy, Cyst-C and UA (r=0.26, 0.30, 0.23, P<0.05), but was negative correlated with HDL-c(r=-0.38, P<0.05). Further more, Logistic regression analy?sis showed that Hcy,Cyst-C and UA were independent risk factors for cIMT. Conclusion Serum levels of Hcy, Cyst-C and UA are closely related to the cIMT,which indicates that they are independent risk factors of cIMT and may be used as mark?ers in judging the developments and preventions of arteriosclerosis.