CAJ | 학술논문

目的：探讨高血压患者同型半胱氨酸（Hcy）水平与左室舒张功能的相关性。方法：对入选的121例原发性高血压患者进行血浆Hcy、常规生化检测及心脏超声检查，以 Hcy＝10 mmol／L为分界线，患者被分为 H型高血压组（高Hcy组，65例）和高血压正常Hcy组（正常Hcy组，56例）。分析血浆Hcy水平与左室舒张功能的相关性。结果：（1） H型高血压占53.7％， H型高血压组男性比例明显高于正常 Hcy组（67.7％比37.5％， P＜0.01）；（2）与正常Hcy组比较， H型高血压组左房内径[LAD ，（34.4±3.3） mm比（37.6±5.4） mm]、左室重量[LVM ，（183.5±37.0） g比（205.6±53.1） g]、左室重量指数[LVMI ，（111.1±19.2） g／m2比（121.2±31.8） g／m2]、二尖瓣舒张早期流速峰值与二尖瓣环舒张早期流速峰值的比值[E／Em ，（8.4±2.6）比（15.3±7.4）]显著增加（P＜0.05或＜0.01）；（3） Pearson相关分析显示， Hcy与LAD、左室舒张末期内径（LVEDd）、E／Em、LVM和LVMI呈正相关（r＝0.247～0.620， P＜0.05或＜0.01）；多元线性逐步回归分析发现血浆 Hcy是E／Em的影响因素（偏回归系数＝0.529， t＝7.599， P＜0.05）。结论：高血压患者同型半胱氨酸水平与左室舒张功能不全呈显著正相关，临床工作中应重视血浆同型半胱氨酸检测。
목적：탐토고혈압환자동형반광안산（Hcy）수평여좌실서장공능적상관성。방법：대입선적121례원발성고혈압환자진행혈장Hcy、상규생화검측급심장초성검사，이 Hcy＝10 mmol／L위분계선，환자피분위 H형고혈압조（고Hcy조，65례）화고혈압정상Hcy조（정상Hcy조，56례）。분석혈장Hcy수평여좌실서장공능적상관성。결과：（1） H형고혈압점53.7％， H형고혈압조남성비례명현고우정상 Hcy조（67.7％비37.5％， P＜0.01）；（2）여정상Hcy조비교， H형고혈압조좌방내경[LAD ，（34.4±3.3） mm비（37.6±5.4） mm]、좌실중량[LVM ，（183.5±37.0） g비（205.6±53.1） g]、좌실중량지수[LVMI ，（111.1±19.2） g／m2비（121.2±31.8） g／m2]、이첨판서장조기류속봉치여이첨판배서장조기류속봉치적비치[E／Em ，（8.4±2.6）비（15.3±7.4）]현저증가（P＜0.05혹＜0.01）；（3） Pearson상관분석현시， Hcy여LAD、좌실서장말기내경（LVEDd）、E／Em、LVM화LVMI정정상관（r＝0.247～0.620， P＜0.05혹＜0.01）；다원선성축보회귀분석발현혈장 Hcy시E／Em적영향인소（편회귀계수＝0.529， t＝7.599， P＜0.05）。결론：고혈압환자동형반광안산수평여좌실서장공능불전정현저정상관，림상공작중응중시혈장동형반광안산검측。
Objective:To explore the correlation between homocysteine (Hcy) level and left ventricular diastolic func‐tion in patients with hypertension .Methods :A total of 121 enrolled patients with essential hypertension received plasma Hcy ,routine biochemical measurement and echocardiography examination .With Hcy=10 mmol/L as the di‐viding line ,patients were divided into H hypertension group (high Hcy group ,n=65) and hypertension with normal level group (normal Hcy group ,n=56) .Correlation between plasma Hcy level and left ventricular diastolic function was analyzed .Results:(1) H hypertension accounted for 53.7% ,male proportion in H hypertension group was sig‐nificantly higher than that of normal Hcy group (67.7% vs .37.5% , P<0.01);(2) Compared with normal Hcy group ,there were significant rise in left atrial diameter [LAD ,(34.4 ± 3.3) mm vs .(37.6 ± 5.4) mm] ,left ven‐tricular mass [LVM ,(183.5 ± 37.0) g vs .(205.6 ± 53.1) g] ,left ventricular mass index [LVMI ,(111.1 ± 19.2) g/m2 vs .(121.2 ± 31.8) g/m2 ] and transmitral early diastolic peak flow velocity/peak velocity of early diastolic mi‐tral annular motion [E/Em ,(8.4 ± 2.6) vs .(15.3 ± 7.4)] in H hypertension group ,P<0.05 or <0.01 ;(3) Pear‐son correlation analysis indicated that Hcy was positively correlated with LAD ,left ventricular end‐diastolic dimen‐sion (LVEDd) ,E/Em ,LVM and LVMI (r=0.247~0.620 , P<0.05 or <0.01);multi‐factor linear gradual re‐gression analysis found that plasma Hcy level ,was influencing factors for E/Em (P=0.529 ,t=7.599 ,P<0.05) . Conclusion:There is a significant positive correlation between plasma homocysteine level and left ventricular diastolic function insufficiency in patients with hypertension .More attention is required for detection of plasma homocysteine level in clinic .