天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (6): 620-623.doi: 10.11958/j.issn.0253-9896.2015.06.011

• 临床研究 • 上一篇    下一篇

H型高血压患者血清Hcy、Cyst-C、UA水平与颈动脉粥样硬化的关系

谢婷 ，何学恕，杨锡恒，戴日新，莫新玲   

  1. 桂林医学院附属医院心血管内科
  • 收稿日期:2015-02-09 修回日期:2015-03-16 出版日期:2015-06-15 发布日期:2015-06-10
  • 通讯作者: 莫新玲 E-mail:glmxl1003@163.com
  • 基金资助:
    国家十二五 “重大新药创制” 科技重大专项(2012ZX09101105)； 桂林市科学研究与技术开发计划项目 （20140120-1-5） ;广西高校
    科学技术研究项目 （KY2015LX265）

Relationship of serum levels of homocysteine， cystain-C and serum uric acid with carotid atherosclerosis in H-type hypertension patients

XIE Ting, HE Xueshu, YANG Xiheng, DAI Rixin, MO Xinling   

  1. Department of Cardiology, the Affiliated Hospital of Guilin Medical University

  • Received:2015-02-09 Revised:2015-03-16 Published:2015-06-15 Online:2015-06-10

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摘要： 目的 探讨 H 型高血压患者血清同型半胱氨酸 （Hcy）、 胱抑素 C(Cyst-C)、 尿酸(UA)水平与颈动脉粥样硬化程度的关系。方法 收集符合入选标准的 132 例 H 型高血压患者， 应用彩色多普勒超声检查仪测定颈动脉内膜中层厚度(cIMT)， 根据颈动脉粥样硬化的程度分为 cIMT 正常组 40 例， cIMT 增厚组 43 例， 颈动脉斑块形成组 49 例。检测并比较 3 组的血清 Hcy、 Cyst-C、 UA、 血糖、 血脂、 尿素氮、 肌酐 （Scr)水平， 分析其与颈动脉 cIMT 的关系； Logistic
回归分析影响颈动脉粥样硬化的因素。结果 3 组间血糖、 尿素氮、 Scr、 三酰甘油 （TG）、 胆固醇 （TC）、 低密度脂蛋白胆固醇（LDL-c）水平差异无统计学意义， 高密度脂蛋白胆固醇（HDL-c）水平颈动脉斑块形成组＜cIMT 增厚组＜cIMT 正常组， Cyst-C 和 UA 均是颈动脉斑块形成组＞cIMT 增厚组＞cIMT 正常组， 颈动脉斑块形成组的 Hcy 高于于cIMT 正常组和 cIMT 增厚组（均 P＜0.05）； cIMT 与 Hcy、 Cyst-C、 UA 呈正相关（r 分别 0.26、 0.30、 0.23， P < 0.05）， 与HDL-c 呈负相关（r=-0.38, P < 0.05)； Logistic 回归分析示 Hcy、 Cyst-C、 UA 是 cIMT 的独立危险因素。结论 H 型高血压患者血清 Hcy、 Cyst-C、 UA 水平是 cIMT 的独立危险因素， 可作为颈动脉粥样硬化的早期预测指标。

关键词: H 型高血压, 同型半胱氨酸, 胱抑素 C, 尿酸, 颈动脉内膜中层厚度, 动脉粥样硬化

Abstract: Objective To investigate the relationship of serum levels of homocysteine, cystain C and uric acid with carotid atherosclerosis in H-type hypertension patients. Methods A total of 132 H-type hypertension patients were collected to be studied. Their carotid intima-media thickness (IMT) was measured by Doppler ultrasonography. And according to the result of carotid artery atherosclerosis, all patients were divided into normal cIMT group (n=40)， thickened cIMT group (n=43) and plague formation group (n=49). Their serum Hcy, Cyst-C, UA, blood glucose, blood lipid, blood urea nitrogen and serum creatinine were compared among three group and their relationship with cIMT were analyzed. Logistic regression was used to screen risk factors for carotid atherosclerosis. Results There was no significant difference in serum levels of blood glucose， blood urea nitrogen, creatinine, serum creatinine (Scr), triglyceride (TG), total cholesterol (TC), low density lippprotein cholesterol (LDL-c) among these three groups (P > 0.05). The level of high-density lipoprotein (HDL-c) in thickened
cIMT group was higher than that in plague formation group, and lower than normal cIMT group, while both serum levels of Cyst-c and UA were lower in thickened cIMT group than those in plague formation group but higher than those in normal cIMT group (P < 0.05). In addition, serum level of Hcy in normal cIMT group was higher than that in thickened cIMT group and plague formation group. The cIMT grade was positively correlated with serum levels of Hcy, Cyst-C and UA (r=0.26,0.30, 0.23, P < 0.05), but was negative correlated with HDL-c（r=-0.38, P < 0.05). Further more, Logistic regression analysis showed that Hcy， Cyst-C and UA were independent risk factors for cIMT. Conclusion Serum levels of Hcy, Cyst-C and UA are closely related to the cIMT， which indicates that they are independent risk factors of cIMT and may be used as markers in judging the developments and preventions of arteriosclerosis．

Key words: H-type hypertension, homocysteine, cystatin C, uric acid, carotis intima-media thickness, atherosclerosis