论文部分内容阅读
目的:研究分析原发性高血压患者血浆同型半胱氨酸(Hcy)水平与靶器官损伤及其并发症间的关系。方法:选取765例住院原发性高血压患者,评估心血管疾病危险因素、靶器官损伤及脑卒中或外周血管病等心血管并发症,并用酶联免疫吸附试验检测其血浆Hcy水平。结果:765例高血压患者平均Hcy水平为14.4μmol/L,男性患者(455例)Hcy水平明显高于女性(310例)[(16.3±6.9)μmol/L比(11.8±4.2)μmol/L](P<0.001)。血浆Hcy与血肌酐(Scr)、肾小球滤过率(GFR)明显相关(P<0.001)。女性患者血浆Hcy还与年龄(P<0.001)、总胆固醇水平(P=0.03)间存在明显相关性;而无论女性或男性患者的血浆Hcy水平与其腰围、BMI、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、C-反应蛋白等心血管危险因素间均无相关性。血浆Hcy水平仅与女性患者左心室质量指数、颈动脉内中膜厚度呈正相关(P=0.031、0.007),但校正Scr后则显示其间亦无相关性(P=0.203、0.071)。血浆Hcy水平与女性患者脑卒中、外周血管病间存在相关性,即使校正Scr、GFR及其他危险因素后仍与脑卒中显著相关(OR=4.10;95%CI:1.16～14.49;P=0.028),而与男性患者脑卒中、外周血管病间无相关性。结论:血浆Hcy水平与原发性高血压患者的Scr及GFR间存在明显相关性,且与女性原发性高血压患者发生脑卒中显著相关。
Objective: To study the relationship between plasma homocysteine (Hcy) levels and target organ damage and its complications in patients with essential hypertension. Methods: A total of 765 inpatients with essential hypertension were enrolled in this study. Cardiovascular complications such as risk factors of cardiovascular diseases, target organ damage and stroke or peripheral vascular disease were evaluated. Plasma homocysteine level was measured by enzyme - linked immunosorbent assay. Results: The mean Hcy level in 765 hypertensive patients was 14.4 μmol / L, and the Hcy level was significantly higher in male patients (455 cases) than in women (310 cases) (16.3 ± 6.9 μmol / L vs 11.8 ± 4.2 μmol / L ] (P <0.001). Plasma Hcy was significantly associated with serum creatinine (Scr) and glomerular filtration rate (GFR) (P <0.001). Hcy in female patients was also significantly correlated with age (P <0.001) and total cholesterol (P = 0.03). However, plasma Hcy levels in female and male patients were significantly correlated with waist circumference, BMI, HDL cholesterol, Lipoprotein cholesterol, fasting blood glucose, C-reactive protein and other cardiovascular risk factors were not related. Plasma Hcy levels were only positively correlated with left ventricular mass index and carotid intima-media thickness in female patients (P = 0.031,0.007), but there was no correlation between plasma Hcy levels and normal controls (P = 0.203,0.071). There was a correlation between plasma Hcy levels and stroke and peripheral vascular disease in female patients, which was still significantly associated with stroke even after adjusting for Scr, GFR and other risk factors (OR = 4.10; 95% CI: 1.16-14.49; P = 0.028) , But no correlation with stroke and peripheral vascular disease in male patients. Conclusion: There is a significant correlation between plasma Hcy levels and Scr and GFR in patients with essential hypertension, and is significantly associated with stroke in women with essential hypertension.