高同型半胱氨酸血症和彩色多普勒检测在高血压肾损害中的临床研究

目的 探讨血浆同型半胱氨酸检测和彩色多普勒肾血流检查在高血压肾损害诊断及治疗中的意义.方法根据高血压肾损害检测指标将72例高血压患者分为3组,检测血浆同型半胱氨酸并测量三级肾血管血流参数,并与正常对照组20例检查结果进行对比;将各组同型半胱氨酸水平与肾叶间动脉阻力指数(RI)进行相关分析.结果①高血压组患者血浆同型半胱氨酸水平明显高于正常对照组(P＜0.01);随着高血压肾损害逐渐加重,血浆同型半胱氨酸水平逐渐增高,高血压各组间比较差异均有统计学意义(P＜0.05).②随着高血压肾损害的加重,各级动脉收缩期最大血流速度(Vmax)、舒张末期最低血流速度(Vmin)逐渐减慢,RI、搏动指数(PI)增高,各组间比较差异有统计学意义(P＜0.01).③血浆同型半胱氨酸与叶间动脉RI存在正相关(r=0.35,P＜0.01).结论高血压患者多普勒频谱的变化可反映肾内血流状态,依据肾叶间动脉RI推测肾内血流状态是可行的.随着高血压肾损害的进展,同型半胱氨酸的水平逐渐增高,可用于评价高血压患者肾损害的严重程度.对高血压肾损害患者肾彩色多普勒检查可估计高同型半胱氨酸血症严重程度及对干预治疗效果进行判断.

Clinical study of homocysteine and color Doppler flow imaging in the diagnosis and treatment in the renal damage of hypertension

Objective To evaluate the significance of homocysteine(HCY)and color Doppler flow imaging(CDFI)in the diagnosis and treatment of the renal damage in hypertension.Methods Seventy-two patients were divided into 3 groups according to the indicators of renal damage of hypertension.HCY in blood and the parameters of three grades renal artery with CDFI were measured and compared with 20 controls.Besides these，the relationship between HCY and resistant index(RI)of interlobar renal artery (IRA)was also analysed.Results ①The level of HCY in hypertension was much more higher than the level in controls.HCY increased with the damage of renal function，and there were significant differences between different groups(P＜0.05).②The Vmax and Vmin were slower gradually，but PI and RI were higher with the severity of the renal damage(P＜0.01).③HCY were positive correlation with IRNs RI(r=0，35，P＜0.0 1).Conclusions The changes of CDFI can reflect the conditions of renal blood flow，it is possible to know renal blood flow by measuring RI of IRA.The level of HCY will increase gradually with the degression of renal function，it iS useful to evaluate the renal damage.The measurement of CDFI for hypertensive patients is valuable not only for the evaluations of their renal function but also for the severity of hyperhomocysteinemal and their therapy condition.