未治疗原发性高血压患者脉搏波速度与血浆同型半胱氨酸水平相关性分析

目的 研究未经治疗的原发性高血压患者各动脉节段脉搏波速度（PWV）变化及其相关因素.方法 选取未经治疗的原发性高血压患者97例,健康对照组97例.采用Complior分析仪测定颈-股动脉脉搏波传导速度（CF-PWV）、颈-桡动脉脉搏波传导速度（CR-PWV）和颈-踝动脉脉搏波传导速度（CA-PWV）.采用全自动生化分析仪检测血糖、血脂、尿酸、同型半胱氨酸、高敏C反应蛋白等血液生化指标.结果 与对照组比较,未治疗的原发性高血压患者CF-PWV、CR-PWV和CA-PWV、血压、心率、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、尿酸和同型半胱氨酸均显著增加（P＜0.05或P＜0.01）.高密度脂蛋白胆固醇、肌酐和高敏C反应蛋白无明显变化.多因素逐步回归分析显示,CF-PWV的独立相关因素是高血压（β=0.333,P＜0.01）、脉压差（β=0.269,P＜0.01）和同型半胱氨酸（β=0.124,P＜0.05）.CR-PWV的独立相关因素是高血压（β=0.376,P＜0.01）、心率（β=0.148,P＜0.05）和同型半胱氨酸（β=0.135,P＜0.05）.CA-PWV的独立相关因素是高血压（β=0.556,P＜0.01）、体质量指数（β=-0.163,P＜0.01）和同型半胱氨酸（β =0.145,P＜0.05）.结论 未治疗原发性高血压患者各动脉节段PWV增加,血浆同型半胱氨酸水平是其独立相关因素之一.

The plasma homocysteine level is associated with increased pulse wave velocities in untreated Chinese patients with essential hypertension

Objective To investigate the association factors of pulse wave velocity（PWV） meas- ured on different sites of artery system in untreated Chinese patients with essential hypertension. Methods A total of 97 untreated Chinese patients with essential hypertension and 97 normal controls were studied. Carotid-femoral PWV （ CF-PWV ） , carotid-radial PWV （ CR-PWV ） and carotid-ankle （ CA-PWV ） were measured using Complior. Plasma homocysteine,uric acid, high sensitivity C reactive protein（hsCRP） and other biochemical parameters were determined by automatic analysis devices. Results Compared with the control group, untreated Chinese patients with essential hypertension had higher values of CF-PWV, CR-PWV, CA-PWV, blood pressure, heart rate, fasting glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol ,uric acidand homocysteine（ P 〈 0.05 or P 〈 0.01 ）. No significant differences of high density lipoprotein cholesterol, creatinine and hsCRP existed between the two groups. Stepwise multi- ple regression analyses showed that hypertension （ β = 0. 333, P 〈 0.01 ） , pulse pressure （ β = 0. 269, P 〈 0.01 ） and homocysteine （ β = 0. 124, P 〈 0.05 ） ）were independent association factors of CF-PWV. Hyper- tension（ β = 0.376, P 〈 0.01 ）, heart rate （ β = 0. 148, P 〈 0.05 ） and homocysteine （ β = 0. 135, P 〈 0.05 ） were independent association factors of CR-PWV. Hypertension （ β = 0. 556, P 〈 0.01 ） , body-mass index（ β = - 0. 163 ,P 〈 0.01 ） and homocysteine （ β = 0. 145, P 〈 0. 05 ） were independent association factors of CA-PWV. Conclusion CF-PWV, CR-PWV and CA-PWV are increased in untreated hyperten- sive Chinese patients and independently associated with plasma homocysteine level.