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目的探讨H型高血压病人合并急性脑梗死同型半胱氨酸(Hcy)、血压、颈动脉斑块的相关性。方法选择高血压伴急性脑梗死病人215例,按3分位数法根据同型半胱氨酸(Hcy)水平分为低Hcy组(n=71)、中Hcy组(n=70)和高Hcy组(n=74),中、高Hcy组,Hcy>11.25μmol/L的高血压病人定为H型高血压。比较3组病人一般资料,分析H型高血压病人急性脑梗死相关影响因素。结果 H型高血压合并急性脑梗死病人男性比例高、年龄增加(P<0.05),总胆固醇、低密度脂蛋白胆固醇水平显著增高,三酰甘油、高密度脂蛋白胆固醇水平则无差别;叶酸、维生素B12水平显著降低(P<0.05)。非H型、H型高血压病人颈动脉斑块包括双侧颈动脉斑块比例差异无统计学意义,但后者双侧颈动脉内膜厚度显著增加。Kendall相关分析H型高血压组Hcy与叶酸、维生素B12呈负相关(P<0.01),低Hcy组则无相关性。结论急性脑梗死伴高血压病人,H型高血压比例66.7%,高龄、男性更多见,颈动脉内膜厚度显著增加,伴随叶酸、维生素B12水平降低。
Objective To investigate the correlation between homocysteine (Hcy), blood pressure and carotid artery plaques in patients with H type hypertension complicated by acute cerebral infarction. Methods A total of 215 patients with hypertension and acute cerebral infarction were enrolled in this study. The patients were divided into low Hcy group (n = 71), middle Hcy group (n = 70) and high Hcy group according to homocysteine (Hcy) Group H (n = 74), medium and high Hcy group, Hcy> 11.25μmol / L of hypertensive patients as Hypertension. The general data of 3 groups of patients were compared to analyze the influencing factors of acute cerebral infarction in Hypertensive patients. Results Hypertension patients with acute cerebral infarction had a higher proportion of male patients and increased age (P <0.05), total cholesterol and low density lipoprotein cholesterol levels were significantly increased, triglyceride and high density lipoprotein cholesterol levels were no difference; folic acid, Vitamin B12 levels were significantly lower (P <0.05). There was no significant difference in carotid artery plaque, including bilateral carotid plaque in non-H type and H type hypertensive patients, but bilateral carotid intima-media thickness in the latter group was significantly increased. Kendall correlation analysis Hypertension Hcy and folic acid, vitamin B12 was negatively correlated (P <0.01), low Hcy group was not related. Conclusion Acute cerebral infarction with hypertension patients, H-type hypertension rate of 66.7%, older, more common in men, carotid artery intima-media thickness was significantly increased, accompanied by folic acid, vitamin B12 levels decreased.