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目的探讨同型半胱氨酸(Hcy)、胰岛素抵抗(IR)与高血压病(PH)合并血管性痴呆(VD)的相关性,为早期发现及治疗高Hcy血症及IR可以预防PH合并VD的发生提供理论依据。方法选择于我院就诊的高血压病患者388例,分为2组,PH合并VD患者96例为病例组,PH不合并VD患者292例为对照组。测定三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹胰岛素(FINS)、空腹葡萄糖(FPG)、Hcy等生化指标,计算胰岛素抵抗指数(IRI)。结果 (1)病例组在TG≥1.88mmol/L、TC≥6.17mmol/L、HDL<1.44mmol/L、LDL≥3.12mmol/L、FINS≥11.0mU/L、IRI≥2.8、Hcy≥14μmol/L时,PH合并VD的发生率显著高于对照组,差异有统计学意义(P<0.05)。(2)应用Lo-gistic回归分析显示:Hcy≥14μmol/L、IRI≥2.8mU/L是预测PH合并VD的主要指标,OR为2.79、7.47,OR95%CI为2.023～4.977,5.843～9.555,P<0.05。结论高Hcy≥14μmol/L、IRI≥2.8mU/L是PH合并VD的主要危险因素。
Objective To investigate the relationship between homocysteine (Hcy), insulin resistance (IR) and hypertension (PH) with vascular dementia (VD). To detect and treat hyperhomocysteinemia and IR in the early stage of PH combined with VD Provide a theoretical basis for the occurrence of. Methods 388 hypertensive patients selected from our hospital were divided into two groups: 96 cases with PH combined with VD and 292 cases with PH without VD. The biochemical indexes of triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting insulin (FINS), fasting glucose (FPG) and Hcy were measured to calculate insulin resistance Index (IRI). Results (1) The cases were treated with TG≥1.88mmol / L, TC≥6.17mmol / L, HDL≤1.44mmol / L, LDL≥3.12mmol / L, FINS≥11.0mU / L, IRI≥2.8, Hcy≥14μmol / L, PH combined with the incidence of VD was significantly higher than the control group, the difference was statistically significant (P <0.05). (2) Lo-gistic regression analysis showed that Hcy≥14μmol / L and IRI≥2.8mU / L were the main indicators for predicting PH combined VD. OR was 2.79,7.47, OR95% CI was 2.023-4.977,5.843-9.555, P <0.05. Conclusion High Hcy≥14μmol / L and IRI≥2.8mU / L are the main risk factors for PH combined with VD.