不同类型老年高血压患者血浆同型半胱氨酸变化与动脉硬化的关系

目的比较不同类型老年高血压患者血浆同型半胱氨酸(Hcy)变化并探讨其与动脉硬化的关系。方法入选在我科住院及门诊就诊的老年高血压患者167例,分为老年单纯收缩期高血压患者(ISH组)79例及老年双期高血压患者(DH组,收缩压及舒张压均升高者)88例,另选择55例健康体检正常的老年人作为对照组,分别测定其血浆Hcy、测量踝肱指数(ABI)、颈动脉内膜中层厚度(IMT),比较各组血浆Hcy水平及其与ABI、IMT相关性。结果吸烟、舒张压水平及血清LDL-C水平3组间比较差异有统计学意义(P<0.05);与对照组比较,ISH组及DH组Hcy水平、IMT明显增高,ABI明显降低(P<0.05);与DH组比较,ISH组Hcy水平、IMT明显增高,差异有统计学意义(P<0.05)。结论老年ISH患者血浆Hcy水平较双期高血压患者及对照组明显增高,且与动脉硬化呈正相关,老年ISH患者在降压达标的同时更应关注降低血浆Hcy浓度。

Relation between plasma homocysteine change and ateriosclerosis in different kinds of elderly hypertensive patients

Objective To study the relation between plasma homocysteine(Hcy) change and ateriosclerosis in different kinds of elderly hypertensive patients.Methods One hundred and sixty-seven hypertensive patients admitted to our department or who visited our outpatient department,included in this study,were divided into simple systolic hypertension group(n=79) and double phase hypertension group(n=88).Fifty-five healthy old subjects undergoing health check served as a control group.Their plasma Hcy level,carotid artery intim-media thickness(IMT) and ankle brachial index(ABI) were measured and compared.Results A significant difference was found in smoking,diastolic pressure and serum LDL-C level among the 3 groups(P<0.05).The serum Hcy level and carotid artery IMT were significantly higher whereas the ABI was significantly lower in simple systolic hypertension group and double phase hypertension group than in control group(P<0.05),and were significantly higher in simple systolic hypertension group than in double phase hypertension group(P<0.05).Conclusion The serum Hcy level is significantly higher in simple systolic hypertension patients than in double phase hypertension patients and is positively related with ateriosclerosis.Serum Hcy level should be decreased while hypertension is controlled in elderly simple systolic hypertension patients.