老年高血压患者心功能、外周血管阻力与血清Hcy、血脂水平的相关性研究

目的探讨老年高血压患者心功能和外周血管阻力的变化,并分析老年高血压患者心功能、外周血管阻力与同型半胱氨酸(Hcy)、血脂水平的相关性。方法选取2017年10月~2019年3月于山西医科大学第一医院老年病科就诊的年龄≥60岁的高血压患者126例为高血压组,并选取同期来院体检年龄≥60岁的健康体检者107名为对照组。分别测定两组血清Hcy、血脂水平,用无创血流动力学检测仪记录心功能、外周血管阻力参数。比较两组Hcy、血脂水平、心功能及外周血管阻力参数变化,分析心功能、外周血管阻力参数与Hcy、血脂水平的相关性。结果高血压组同型半胱氨酸(Hcy)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)高于对照组(P<0.05),高密度脂蛋白胆固醇(HDL-C)低于对照组(P<0.05);高血压组的外周血管阻力参数每搏外周阻力(SSVR)、系统阻力(SVR)均高于对照组(P<0.05);心功能参数心输出量(CO)、每搏量(SV)、左室每搏做功(LSW)、左室射血时间(LVET)均低于对照组(P<0.05)。Pearson相关性分析显示,高血压组心输出量(CO)与Hcy、TC、LDL-C呈负相关,每搏量(SV)与Hcy呈负相关,左室每搏做功(LSW)与Hcy、LDL-C呈负相关,左室射血时间(LVET)与Hcy呈负相关,外周血管阻力指标SSVR、SVR与Hcy、TC、TG、LDL-C呈正相关,SVR与HDL-C呈负相关。结论老年高血压患者的心功能,包括心排量和心肌收缩力均显著减低,外周血管阻力显著增加,并且这种血流动力学的紊乱与Hcy、血脂水平相关。

Clinical study on changes of cardiac function and peripheral vascular resistance in elderly patients with hypertension

Objective To investigate the changes of cardiac function and peripheral vascular resistance in elderly patiants with hypertention and their correlation with homocysteine(Hcy)and lipid levels.Methods 126 hypertensive patients aged≥60 years in the department of geriatrics,the first hospital of shanxi medical university from October 2017 to March 2019 were selected as the hypertension group,and 107 healthy patients aged≥60 years in the same period were selected as the control group.Serum Hcy and lipid levels in the two groups were measured,and parameters of cardiac function and peripheral vascular resistance were recorded by non-invasive hemodynamic detector.The changes of Hcy,lipid profile,cardiac function and peripheral vascular resistance parameters in the two groups were compared,and the correlation between cardiac function and peripheral vascular resistance parameters and Hcy and lipid profile was analyzed.Results Hcy,total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the hypertension group were higher than those in the control group(P<0.05),while high-density lipoprotein cholesterol(HDL-C)was lower than those in the control group(P<0.05).Peripheral vascular resistance(SSVR)and systemic resistance(SVR)in the hypertensive group were higher than those in the control group(P<0.05),and cardiac function parameters(CO),SV,LSW and LVET were lower than those in the control group(P<0.05).Pearson correlation analysis showed that hypertension group CO and Hcy in cardiac output,and negatively correlated with TC,LDL-C,stroke volume SV and negatively correlated with Hcy,left ventricular stroke work LSW and negatively correlated with Hcy,LDL-C,left ventricular ejection time(LVET)and negatively correlated with Hcy,peripheral vascular resistance index SSVR,SVR and Hcy,TC,TG,LDL-C were positively correlated,and negatively correlated with the SVR and HDL-C.Conclusion In elderly patients with hypertension,cardiac function,including cardiac displacement and myocardial contractility,was significantly reduced,and peripheral vascular resistance was significantly increased.Moreover,such hemodynamic disorder was associated with Hcy and lipid levels.