同型半胱氨酸与老年下肢动脉粥样硬化性疾病的关系

目的探讨血浆同型半胱氨酸(Hcy)与老年下肢动脉粥样硬化性疾病(LEAD)的关系。方法顺序入选217例老年患者,根据踝臂指数(ABI)分为下肢动脉正常组和LEAD组,采集吸烟、高血压、糖尿病、高脂血症、冠心病、脑卒中史,分别检测Hcy、肌酐(Cr)、尿酸(UA)、胱抑素C(Cys-C)、总胆固醇(TC)、三酰甘油(TG)、高密度胆固醇(HDL-C)、低密度胆固醇(LDL-C)以及血压(BP)、体质量指数(BMI)、腹围,并对各组化验指标进行统计学分析及多元回归分析。结果两组间年龄、性别、腹围、BMI、舒张压(DBP)、Cr、Cys-C、FBG、TC、TG、LDL-C以及高血压、糖尿病、高脂血症病史差异无统计学意义(P>0.05);LEAD组Hcy、UA、收缩压、脉压以及吸烟、冠心病、脑卒中史明显高于正常组(P<0.05),ABI、HDL-C明显低于正常组(P<0.05);多元线性回归分析显示Hcy与LEAD正相关。结论高同型半胱氨酸血症是老年心血管疾病的重要危险因素,应积极干预。

The relationship between homocysteine and lower extremity atherosclerotic disease in the elderly patients

Objective To study the relationship between plasma homocysteine（Hcy） and lower extremity atherosclerotic disease（LEAD） in the elderly patients.Methods A total of 217 elderly patients were selected in sequence,which were divided into normal group and lower extremity atherosclerotic disease（LEAD） group according to the ankle-brachial index（ABI）.The medical history including smoking,hypertension,diabetes,hyperlipidemia,coronary heart disease and stroke was recorded.The biochemical indicators including Hcy,creatinine（Cr）,uric acid（UA）,cystatin C（Cys-C）,total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C） and blood pressure（BP）,body mass index（BMI）,abdominal circumference were collected.And laboratory parameters in each group were retrospectively analyzed using multiple regression analysis.Results The age,gender,abdominal circumference,BMI,diastolic blood pressure（DBP）,Cr,Cys-C,fasting blood glucose（FBG）,TC,TG,LDL-C and the history of high blood pressure,diabetes,hyperlipidemia of the two groups were no significantly difference（P 0.05）.Hcy,UA,systolic blood pressure（SBP） and pulse pressure（PP） were significantly higher in the LEAD group than those in the normal group（P 0.05）.And there were significantly more patients who had the history of smoking,coronary heart disease or stroke in the LEAD group（P 0.05）.ABI and HDL-C were significantly lower in the LEAD group than those in the normal group（P 0.05）.Multiple regression analysis showed that Hcy was positively associated with LEAD（P 0.05）.Conclusions The high hyperhomocysteinemia（HH） is an important risk factor of cardiovascular disease,which should be intervened actively.