高同型半胱氨酸血症患者炎性反应 血管内皮功能 脉搏波速度的表达

目的观察高同型半胱氨酸（Hcy）血症患者炎性反应、血管内皮功能、脉搏波速度的表达。方法选取2012年6月至2013年3月在该院体检中心体检的人群，无高血压、冠心病、糖尿病、脑梗死、肝肾功能不全等病史，依据Hcy水平分为A、B、C、D4组，A组（Hcy〈10μmol／L）、B组（10μmol／L≤Hcy〈15μmol／L）、C组（15μmol／L≤Hcy〈20μmol／L）、D组（Hcy≥20μmol／L），对入组人群行超敏c反应蛋白（hs—CRP）、血流介导的血管舒张反应（FMD）、硝酸甘油介导的血管舒张反应（NMD）、踝臂脉搏波速度（ba—PWV）检测。结果高Hcy各组hs—CRP、ba-PWV均高于Hcy正常组，FMD、NMD低于Hcy正常组，且c、D组与Hcy正常组比较差异有统计学意义（P〈0．05），D组与B组比较差异有统计学意义（P〈0．05）。对Hcy与ba-PWV进行相关分析，显示二者呈正相关（r=0．467，P〈0．05），Hcy与hscRP差异无统计学意义（P〉0．05）。结论高Hcy组患者炎性反应、动脉僵硬度较明显，血管内皮功能较差，且这种变化随着Hcy水平的升高而更加明显。

To observe the inflammatory reaction,Vascular endothelial function and Brachial ankle pulse wave velocity in patients with hyperhomocystinemia

Objective To observe the inflammatory reaction,Vascular endothelial function and brachial ankle pulse wave velocity （ba-PWV） in patients with hyperhomocystinemia. Methods 120 patients from our hospital＇s medical examination center from 2012.6 to 2013.3 without hypertension, coronary heart disease, diabetes, cerebral in- farction,liver and kidney dysfunction history were chosen. On the basis of homocysteine level, all the patients were di vided into group A （Hcy〈10 μmol/L） ,group B （10 μmol/L≤ Hcy〈15μmol/L） ,group C （15 μmol/L ≤Hcy〈20 μmol/L） ,and group D（ Hcy~20μmol/L）. The hs-CRP, flow-mediated dilatation （FMD）, nitroglycerin-mediated dil- atation （NMD） ,and ba-PWV were measured. Results To compare with group A,there were higher levels of hs-CRP and ba-PWV and lower levels of FMD and NMD in group B, group C and group D, there were statistically significant between group C,D and group A （P〈0.05） ,and there was significant difference between group D and group B （P〈 0.05）. Hcy had the positive relationship with ba-PWV （r= 0. 467 ,P〈0.05）, and there was no significant correlation between Hcy and hs-CRP（P〉0.05）. Conclusion Patients with hyperhomocystinemia have serious inflammatory re- action,arterial stiffness and worse vascular endothelial function than the patients with normal homocysteine,and the change was obvious with elevated homocysteine levels.