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[目的]探讨血浆同型半胱氨酸(HCY)在高血压病合并糖尿病患者中的变化及意义。[方法]采用循环酶法检测56例高血压病合并糖尿病患者、42例高血压患者和40例健康对照者血浆中HCY水平,分析在高血压病合并糖尿病患者中HCY与胰岛素敏感性指数(ISI)和颈动脉内-中膜厚度(IMT)的关系。[结果]高血压组HCY和IMT水平明显高于对照组,差异有统计学意义(P﹤0.05);ISI与对照组比较差异无统计学意义(P﹥0.05)。高血压合并糖尿病组HCY和IMT水平明显高于对照组和高血压组(P﹤0.05),ISI水平明显低于对照组和高血压组(P﹤0.05)。高HCY血症亚组的ISI明显低于无高HCY血症亚组,IMT明显高于无高HCY血症亚组,两组比较差异有统计学意义(P﹤0.05)。[结论]血浆HCY在高血压合并糖尿病患者中明显升高,并且与胰岛素抵抗和颈动脉粥样硬化密切相关。
[Objective] To investigate the changes and significance of plasma homocysteine (HCY) in patients with hypertension and diabetes mellitus. [Methods] The levels of HCY in 56 hypertensive patients with diabetes mellitus, 42 hypertensive patients and 40 healthy controls were detected by enzymatic cycling method. The levels of HCY and insulin sensitivity index (ISI) in hypertensive patients with diabetes mellitus ) And carotid intima-media thickness (IMT). [Results] The levels of HCY and IMT in hypertension group were significantly higher than those in control group (P <0.05). There was no significant difference between ISI and control group (P> 0.05). The levels of HCY and IMT in hypertensive patients with diabetes mellitus were significantly higher than those in the control group and the hypertensive group (P <0.05), and the levels of ISI in the hypertensive diabetic group were significantly lower than those in the control group and the hypertensive group (P <0.05). The ISI in subgroup of hypercholesterolemia was significantly lower than that in subgroup without hypercholesteremia, IMT was significantly higher than that in subgroup without hypercholesterolemia, the difference was statistically significant (P <0.05). [Conclusion] Plasma HCY is significantly elevated in hypertensive patients with diabetes and is closely related to insulin resistance and carotid atherosclerosis.