张艳玲 阴瑞红 左希宏

[摘要] 目的 探讨原发性高血压患者血清同型半胱氨酸水平（Hcy）、肱踝脉搏波传导速度（BaPWV）及左室质量指数（LVMI）的相关性。 方法 入选2013年6月～2015年6月在我院就诊的150例原发性高血压患者，根据血Hcy水平分为H型高血压组（H组，Hcy≥10 μmol/L）与非H型高血压组，分别进行BaPWV及超声心动图测定。 结果 H型高血压组与非H型高血压组的BaPWV及左室质量指数（LVMI）均显著高于对照组，差异有统计学意义（P<0.01）；其中H型高血压组显著高于非H型高血压组，差异有统计学意义（P<0.01）。血清Hcy水平与BaPWV（r=0.723，P<0.01）及LVMI（r=0.917，P<0.01）呈正相关。 结论 高血压患者血清同型半胱氨酸升高者往往伴有外周血管及心脏靶器官损害，且血清Hcy水平与高血压病患者外周动脉疾病及左室肥厚之间有明显的相关性。

[关键词] 原发性高血压；同型半胱氨酸；脉搏波传导速度；左室质量指数

[中图分类号] R544.11 [文献标识码] A [文章编号] 1673-9701（2016）06-0009-03

Correlation between serum homocysteine， pulse wave velocity and left ventricular mass in patients with essential hypertension

ZHANG Yanling YIN Ruihong ZUO Xihong

Department of Cardiology，Ji'nan First People's Hospital， Ji'nan 250013，China

[Abstract] Objective To investigate the relationship between plasma homocysteine level（Hcy）， brachial ankle pulse wave velocity （BaPWV） and left ventricular mass index （LVMI） in patients with essential hypertension. Methods Selected from June 2013 to June 2015 in our hospital of 150 cases of primary hypertension patients， according to the level of blood Hcy they were divided into H type hypertension group （group H， Hcy≥10 μmol/L） and non H type hypertension group， BaPWV and echocardiography were performed respectively. Results The BaPWV and left ventricular mass index（LVMI） of H type hypertension group and non H group were significantly higher than those in the control group， and the difference was statistically significant（P<0.01）， and the H group was significantly higher than that in non H group， and the difference was statistically significant（P<0.01）. Serum Hcy level was positively correlated with BaPWV （r=0.723， P<0.01） and LVMI（r=0.917， P<0.01）. Conclusion Elevated blood homocysteine levels in patients with hypertension are associated with peripheral vascular and cardiac target organ damage， and there is a significant correlation between Hcy levels and peripheral arterial disease and left ventricular hypertrophy in patients with essential hypertension.

[Key words] Essential hypertension； Homocysteine； Pulse wave velocity； Left ventricular mass index

H型高血压是指伴有血清同型半胱氨酸（Hcy）增高的原发性高血压[1]，在我国高血压患者中约占原发性高血压的75%。高血压合并高Hcy可显著增加血管疾病的风险[2]。高血压靶器官损害的基础是血管损害，脉搏波传导速度（PWV）是反映动脉壁硬度，评价动脉硬化的早期指标[3]。左心室肥厚是高血压常见的靶器官损害之一，严重危害人类健康。本研究旨在探讨原发性高血压患者，血清Hcy水平与BaPWV及左室质量的相关性，为高血压心脑血管并发症的早期防治提供有效临床依据。

1 对象与方法

1.1 研究对象

选取2013年6月～2015年6月在我院心内科住院和门诊就诊的原发性高血压患者150例，纳入标准：①所选患者均符合《中国高血压防治指南》2010年修订版[4]原发性高血压的诊断标准；②H型高血压：Hcy≥10 μmol/L的原发性高血压[1]。排除标准：①继发性高血压患者；②伴有收缩性心力衰竭、心肌梗死、严重肝肾功能不全、合并感染性疾病的患者；③糖尿病患者；……