有效控制“H型”高血压 —— 预防卒中的新思路

  目的  了解高原世居藏族血浆同型半胱氨酸（Hcy）水平与5,10-亚甲基四氢叶酸还原酶（MTHFR）及甲硫氨酸合成还原酶（MTRR）基因多态性。  方法  于2017年6 — 7月，采用单纯随机抽样方法，在西藏自治区拉萨市城关区（海拔3 650 m）抽取447名30～70岁的藏族居民；检测血浆Hcy水平、MTHFR C677T、MTRR A66G位点基因多态性，应用SPSS 17.0软件处理数据。  结果  血浆Hcy水平为15.40（13.40，17.90）μmol/L，除在61～70岁年龄组性别没有统计学差异外，男性的Hcy水平[16.55（14.40，19.68）]均高于女性[15.00（12.90，16.90）]（P < 0.05）；H型高血压的患病率为13.9 %（62/447），检出率为60.2 %（62/103）；血浆Hcy水平在MTHFR C677T TT型最高，组间具有统计学差异（P < 0.05）；影响H型高血压的因素是年龄、收缩压、性别和MTHFR C677T（P < 0.05）。  结论  高原世居藏族男性、> 60岁女性、TT型人群是健康管理的重点。

Vascular pathology of homocysteinemia: implica-tions for the pathogenesis of arteriosclerosis

  Objective  To investigate plasma homocysteine (Hcy) level and 5,10-methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) gene polymorphism among native Tibetans.  Methods  Totally 447 Tibetan residents aged 30 – 70 years were selected with simple random sampling from Chengguan district (3 650 meters above sea level) in Lhasa city, Tibet Autonomous Region from June to July 2017. The residents' plasma Hcy level, MTHFR C677T and MTRR A66G locus gene polymorphism were detected. SPSS 17.0 software was used in data analysis.  Results  The median (25th percentile, 75th percentile) of plasma Hcy was 15.40 (13.40, 17.90) μmol/L for all the residents; the Hcy median of the male residents was higher than that of the female residents (16.55 [14.40,19.68] vs. 15.00 [12.90, 16.90)] (P < 0.05), but the disparity was not observed among the residents aged 61 – 70 years. Among all the residents, the prevalence rate of H-type hypertension was 13.9% (62/447), and the detection rate of H-type hypertension was 60.2% (62/103) in the hypertensives. The plasma Hcy level was significantly higher in the residents with TT type of MTHFR C677T locus (P < 0.05). The influencing factors of H-type hypertension were age, systolic blood pressure, gender, and genotype of MTHFR C677T (P < 0.05 for all).  Conclusion  The men, the women over 60 years old, and the people with TT type of MTHFR C677T are focus groups for health management among native Tibetans.