朱杰（上海市杨浦区五角场镇社区卫生服务中心 上海 200433）

老年高血压患者同型半胱氨酸升高伴血脂异常分析

朱杰
（上海市杨浦区五角场镇社区卫生服务中心 上海 200433）

摘 要目的：研究老年高血压伴同型半胱氨酸（Hcy）患者的血脂情况，探讨Hcy对动脉粥样硬化的可能影响。方法：收集中心2013年2月至2014年2月间诊治的老年高血压患者80例为研究对象，根据Hcy数值分为H型高血压组和非H型高血压组，检测并比较两组患者的Hcy及血脂水平。结果：H型高血压患者较多，为48例（60%），非H型高血压患者为32例（40%）。H型高血压组的低密度胆固醇水平明显高于非H型高血压组，而高密度胆固醇及载脂蛋白A明显低于非H型高血压组，差异均有统计学意义（P<0.05）。结论：老年高血压患者较多伴有Hcy升高，同时预示其血脂异常，与动脉粥样硬化病变的发生可能相关。

关键词高血压 同型半胱氨酸 血脂 老年

Analysis of the homocysteine with dyslipidemia of the elderly patients with hypertension

ZHU Jie
(Wujiaochang Town Community Health Service Center of Yangpu District, Shanghai 200433, China)

ABSTRACTObjective: To study the blood lipid of the elderly patients with hypertension accompanied by homocysteine (Hcy) and to explore the possible impact of Hcy on the atherosclerosis. Methods: Eighty cases of the elderly patients with hypertension who were diagnosed and treated in this center from Feb. 2013 to Feb. 2014 were selected as the research subjects, and divided into an H type hypertension group and a non-H type hypertension group according to the Hcy values, and their levels of Hcy and blood lipid were detected and compared. Results: There were more H type hypertensive patients with 48 cases (60%), and non-H ones, 32 (40%). The LDL level of the patients in the H type hypertension group was obviously higher than that in the non-H type hypertension group. The HDL and lipoprotein in the H type hypertension group was obviously lower than those in the non-H hypertension group, and their difference had the statistical significance (P<0.05). Conclusion: The elderly patients with hypertension are commonly accompanied with the elevated Hcy level which at the same time indicates the blood lipid abnormality, and is closely related to the occurrence of atherosclerotic lesions.

KEY WORDShypertension; homocysteine; blood lipid; elderly people

同型半胱氨酸(Hcy)是一种含硫氨基酸，主要是半胱氨酸和蛋氨酸代谢的中间产物[1]。目前认为Hcy可以作为老年人心脑血管疾病的一项独立的危险因素，并逐渐受到重视。相关研究显示，老年人Hcy型(H型)高血压较非H型高血压多见，H型高血压患者因动脉粥样硬化引起的心、脑、肾损害较多。有关Hcy与脂质的相关性，如Hcy能影响脂质代谢、引起脂质氧化及导致炎症等已有较多报道。本文探讨老年H型高血压对动脉粥样硬化发生的可能影响。

1 一般资料

1.1 研究对象

收集本中心2013年2月至2014年2月间诊治的老年高血压患者80例，根据Hcy值分为H型高血压组（Hcy≥15 μmol/L）和非H型高血压组(Hcy<15 μmol/L)。其中H型高血压组患者共48例，男26例，女22例，年龄62~82岁，平均动脉压为（95.0±7.8）mmHg；非H型高血压组患者32例，男18例，女14例，年龄68~80岁。患者均为老年人，年龄≥60岁，平均动脉压为（105.0±8.2）mmHg。依据《2005年中国高血压防治指南诊断标准》明确诊断为原发性高血压，无严重心、脑、肝、肾等基

础疾病患者，无继发性高血压。

1.2 研究方法

采集患者清晨空腹静脉血，检测Hcy及三酰甘油（TG）、总胆固醇（TC）、低密度胆固醇（LDL）、高密度胆固醇（HDL）、载脂蛋白A水平。……