高敏C反应蛋白、同型半胱氨酸与高血压颈动脉粥样硬化的相关性研究

目的探讨原发性高血压（EH）患者高敏C反应蛋白（hs—CRP）、同型半胱氨酸（Hcy）与颈动脉内膜-中层厚度（IMT）的相关性。方法选择初发未经降压治疗的EH患者128例作为高血压组，检测血压、身高、体重、体质量指数（BMI）及生化指标，采用胶乳免疫比浊定量法测hs—CRP，循环酶法测Hcy水平。按照中国高血压防治指南标准将EH患者分为高血压1级组（43例）、高血压2级组（46例）和高血压3级组（39例），并对EH患者依据颈动脉超声结果将其分为无病变组（48例）、内膜增厚组（42例）和斑块组（38例）三个亚组。以40名健康人作为正常对照组。结果高血压组hs—CRP、Hcy水平均显著高于正常对照组，差异有统计学意义（P〈0．01）。高血压患者不同血压级别组间hs—CRP、Hcy水平比较，hs—CRP水平在各组间差异均有统计学意义（P〈0．01），而Hey水平在各组间差异均无统计学意义（P〉O．05）；高血压合并不同程度颈动脉硬化组间hs—CRP、Hey水平比较，hs—CRP、Hcy水平斑块组和内膜增厚组高于无病变组，斑块组又明显高于内膜增厚组，差异均有统计学意义（P〈0．01）。进一步相关分析显示，IMT除与年龄、BMI、收缩压、舒张压、脉压、LDL呈正相关（P〈0．05或P〈0．01）外，同时与hs—CRP、Hcy呈正相关（r=0．610和r=0．571，P〈0．01）。结论ha—CRP、Hey与EH患者颈动脉粥样硬化（CAS）的发生发展有关，提示早期干预炎症反应及高Hcy血症可延缓动脉粥样硬化的进程。

Analysis of relationship between high sensitivity C-reactive protein, homocysteine and carotid atherosclerosis plaque in essential hypertension

Objective To investigate the correlation between the high sensitivity C-reactive protein （hs- CRP）, homocysteine （Hey） level and carotid atherosclerosis （CAS） in essential hypertension （EH）. Methods Hs-CRP level （was determined by latex immune truidmetric quantitative method）, Hey level（was determined by circulation enzyme method） and common carotid artery and plaque formation in totally 128 essential hypertension patients were determined and compared to those in 40 health people as the control group. Then patients were redi- vided into three different grades of EH according to the standard of diagnosing EH, and three sub-groups accord- ing to the result of B-mode ultrasound examination. Results Hs-CRP and Hey level in the EH were higher than the control group, and show statistical differences in EH compared with the control group （P〈0.01）. To compare the hs-CRP and Hey level in three different grades of EH, hs-CRP level was significant in three different grades of EH （P〈0.01）, but Hcy levels was unremarkable in three different grades of EH （P〉0.05）; hs-CRP and Hcy level were different greatly in three sub-group（P〈0.01）. Intima media thickness （IMT） was related to age, BMI, SBP, DBP, PP, LDL, hs-CRP and Hcy respectively. Conclusion Hs-CRP and Hcy is in correlation to the oc- curing and developing of CAS. The result suggest that to intervene the inflammatory reaction and hyperhomocysteinemia in the initial stage of the disease can delay the progression of atherosclerosis.