急性缺血性脑卒中伴有H型高血压患者血HCY与颈动脉风险指标的相关研究*

doi:10.3969/j.issn.1671-2587.2019.02.017

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (2): 173-177.DOI: 10.3969/j.issn.1671-2587.2019.02.017

急性缺血性脑卒中伴有H型高血压患者血HCY与颈动脉风险指标的相关研究*

汪国宏, 朱幼玲, 吴建贤, 董斌, 张留福

230061 合肥,安徽医科大学第三附属医院,合肥市第一人民医院（汪国宏,朱幼玲,董斌,张留福）; 安徽医科大学第二附属医院（吴建贤）

收稿日期:2018-12-14 出版日期:2019-04-20 发布日期:2019-04-10
作者简介:汪国宏（1978-）,男,安徽铜陵人,主治医师,硕士,主要从事脑血管病的基础及诊治方面研究,（Tel）13505612052（E-mail）57989234@qq.com。
基金资助:
*本课题受合肥市第五周期医学重点学科建设项目(No.YW20171012002),合肥市科技局“借转补”科研项目（合科（2017）112号）资助

Study on Correlation between HCY Level and Carotid Artery Related Indicators in the Cases of Acute Ischemic Stroke Complicated with H-type Hypertension

WANG Guo-hong, ZHU You-ling, WU Jian-xian, et al

The Third Affiliated Hospital of Anhui Medical University,The First People's Hospital of Hefei,Hefei 230061

Received:2018-12-14 Online:2019-04-20 Published:2019-04-10

摘要/Abstract

摘要： 目的分析临床中急性缺血性脑卒中伴有H 型高血压患者血浆同型半胱氨酸（HCY）水平与颈动脉相关风险指标如颈动脉粥样斑块及颈动脉内膜中层厚度(CIMT)的相互关系。方法取本院收治的急性缺血性脑卒中合并H型高血压患者115例为A组,同期收治的急性缺血性脑卒中合并单纯高血压患者68例为B组,同期收治的急性缺血性脑卒中患者110例为C 组。测定3组患者的收缩压（SBP）、舒张压（DBP）、同型半胱氨酸(HCY) 、血脂水平,检测其颈动脉斑块及CIMT,分析血压、HCY 水平、血脂与颈动脉斑块及CIMT之间的相关性。结果三组间总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇( HDL-C)比较,差异无统计学意义(P>0.05);A组SBP、DBP及甘油三酯(TG)高于B组和C组,而B组SBP、DBP高于C组,两者差异均有统计学意义(P<0.05);TG在B、C两组中的分布未见明显差异（P>0.05）。HCY及CIMT值A组高于B、C两组(P<0.05),B、C两组间比较,差异无统计学意义(P>0.05)。3组患者斑块检测情况比较,差异有统计学意义(χ²=13.346,P<0.05)。Pearson 线性相关分析显示,急性缺血性脑卒中合并高血压患者的HCY水平与CIMT、斑块呈正相关(r=0.545,P<0.01) 。结论急性缺血性脑卒中合并高血压患者的HCY水平与CIMT 、颈动脉斑块形成等颈动脉风险指标呈正相关,HCY是CIMT增高与动脉粥样硬化斑块形成的独立危险因素。HCY及CIMT、颈动脉斑块的检测,对于评估和治疗急性缺血性脑卒中合并H型高血压患者具有重要的临床指导作用。

关键词: 同型半胱氨酸, 急性缺血性脑卒中, H型高血压, 颈动脉斑块, 颈动脉内膜中层厚度

Abstract: Objective To analyze the correlation between plasma homocysteine (HCY) level and carotid artery related risk indicators (such as carotid atherosclerotic plaque and CIMT) in acute ischemic stroke patients with H-type hypertension. Methods 115 cases of acute ischemic stroke complicated with H-type hypertension were selected as group A,68 cases of acute ischemic stroke complicated with simple hypertension as group B and 110 cases of acute ischemic stroke as group C. Systolic blood pressure,diastolic blood pressure,homocysteine (HCY),blood lipid levels were measured and carotid plaque and CIMT were detected in the three groups; the correlation between blood pressure,HCY level,blood lipid,carotid plaque and CIMT were analyzed. Results There was no significant difference in TC,LDL-C and HDL-C between the three groups (P>0.05); SBP,DBP and TG in group A were higher than those in group B and group C with statistical difference (P<0.05); SBP and DBP in group B were higher than those in group C with statistical difference (P<0.05); there was no significant difference in the distribution of TG in group B and group C (P>0.05). Hcy and CIMT in group A were higher than those in group B and group C (P<0.05),and HCY and CIMT had no statistical difference between group B and group C (P>0.05). Carotid plaque was detected between the three groups as χ²=13.346 (2=13.346) and bilateral P=0.001,and the difference was statistically significant (P<0.05) according to the level of alpha=0.05. Pearson linear correlation analysis showed that HCY level was positively correlated with CIMT and carotid plaque in the cases of acute ischemic stroke complicated with hypertension (r=0.545,P<0.01). Conclusion HCY in the cases of acute ischemic stroke complicated with hypertension are positively correlated with such common carotid artery risk indicators as CIMT and carotid plaque formation. H-type hypertension is an independent risk factor for increased CIMT and plaque formation. Detection of HCY,CIMT and atherosclerotic plaque plays an important role in evaluation and treatment of acute ischemic stroke complicated with H-type hypertension.

Key words: Homocysteine（HCY）, Acute ischemic stroke, H-type hypertension, Carotid plaque, CIMT

中图分类号:

R743.3R54

汪国宏, 朱幼玲, 吴建贤, 董斌, 张留福. 急性缺血性脑卒中伴有H型高血压患者血HCY与颈动脉风险指标的相关研究*[J]. 临床输血与检验, 2019, 21(2): 173-177.

WANG Guo-hong, ZHU You-ling, WU Jian-xian, et al. Study on Correlation between HCY Level and Carotid Artery Related Indicators in the Cases of Acute Ischemic Stroke Complicated with H-type Hypertension[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2019, 21(2): 173-177.

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急性缺血性脑卒中伴有H型高血压患者血HCY与颈动脉风险指标的相关研究*

Study on Correlation between HCY Level and Carotid Artery Related Indicators in the Cases of Acute Ischemic Stroke Complicated with H-type Hypertension

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