黄朝发 李乐亮 张榕华

摘 要 目的：探讨同型半胱氨酸（Hcy）、脑钠肽（BNP）与H型高血压冠心病患者冠状动脉病变间的关系。方法：纳入2020年4月—2021年3月江西省上饶市广信区人民医院收治的H型高血压冠心病患者40例和非H型高血压冠心病患者40例。比较两组患者冠状动脉病变情况以及血脂指标、血浆Hcy和BNP值，进一步比较H型高血压患者不同冠状动脉病变支数血浆Hcy、BNP值的差异。结果：H型高血压组患者冠状动脉病变程度高于非H型高血压组（P<0.05）。H型高血压组患者血浆Hcy、BNP值均高于非H型高血压组（P<0.05）。不同冠状动脉病变支数血浆Hcy、BNP值均为单支病变<双支病变<三支病变（P<0.05）。结论：H型高血压冠心病患者血浆Hcy、BNP值与冠状动脉病变程度呈正相关，可以反应患者的病情严重度。

关键词 H型高血压；冠心病；Hcy；BNP；冠状动脉病变

中图分类号：R544.1 文献标志码：A 文章编号：1006-1533（2021）24-0020-03

Relationship between homocysteine， brain natriuretic peptide and coronary artery disease in patients with H-type hypertension and coronary heart disease

HUANG Chaofa， LI Leliang， ZHANG Ronghua（Internal Medicine-Cardiovascular Department of People’s Hospital of Guangxin District， Shangrao， Jiangxi 334100， China）

ABSTRACT Objective： To explore the relationship between homocysteine（Hcy）， brain natriuretic peptide（BNP） and coronary artery disease in patients with H-type hypertension and coronary heart disease. Methods： From April 2020 to March 2021， 40 patients with H-type hypertension and coronary heart disease and 40 patients with non-H-type hypertension and coronary heart disease admitted to and treated in the People’s Hospital of Guangxin District， Shangrao City， Jiangxi Province were included. The conditions of coronary artery disease， blood lipid indexes， plasma Hcy and BNP values between the two groups of patients were compared， and the differences of plasma Hcy and BNP values of different coronary artery diseased branches in patients with H-type hypertension were further compared. Results： The degree of coronary artery disease in the H-type hypertension group was higher than that in the non-H-type hypertension group（P<0.05）. The plasma Hcy and BNP values in H-type hypertension group were higher than those in non-H-type hypertension group（P<0.05）. The plasma Hcy and BNP values of different coronary artery diseased branches were single-vessel disease < double-vessel disease < three-vessel disease（P<0.05）. Conclusion： The plasma Hcy and BNP values of patients with H-type hypertension and coronary heart disease are positively correlated with the degree of coronary artery disease， which can reflect the severity of the patient’s condition.

KEY WORDS H-type hypertension； coronary heart disease； homocysteine； brain natriuretic peptide； coronary artery disease

高血壓冠心病是指患者不仅患有高血压，还患有冠心病。高血压冠心病的主要病理基础是冠状动脉粥样硬化。近几年越来越多的研究报道指出同型半胱氨酸（homocysteine，Hcy）与动脉粥样硬化有紧密联系[1]。伴有高Hcy血症（Hcy≥10 mmol/L）的原发性高血压称为H型高血压。有专家指出H型高血压患者冠心病发病率明显升高[2]。也有研究报道认为，冠心病患者病情严重度可能与高Hcy以及脑钠肽（BNP）水平相关[3]。为明确Hcy、BNP与冠状动脉病变间的关系，本院深入分析了H型高血压冠心病患者与非H型高血压冠心病患者Hcy、BNP水平的差异及对冠状动脉病变的影响，报道如下。

1.1 一般资料

纳入2020年4月—2021年3月江……