2019 年第 11 期 第 14 卷

血浆同型半胱氨酸和高敏C反应蛋白水平与H型高血压患者左心室肥厚的关系

Relation of plasma homocysteine and high sensitive C-reactive protein with left ventricular hypertrophy in patients with H-type hypertension

作者：王红康小琴谢文博樊世明柴秀英田辉珍

英文作者：

单位：810001西宁，青海大学附属医院心内科

英文单位：

关键词：高血压；同型半胱氨酸；超敏C反应蛋白；左心室肥厚；危险因素

英文关键词：

• 摘要：

• 【摘要】目的    探讨血浆同型半胱氨酸（Hcy）、高敏C反应蛋白（hs-CRP）水平与H型高血压患者左心室肥厚的关系。方法    选择2018年1—12月于青海大学附属医院就诊的原发性H型高血压患者137例，采用超声心动仪检测并计算左心室质量指数（LVMI），依据LVMI将患者分为左心室增厚组（78例）和左心室正常组（59例）。检测2组患者收缩压、舒张压、hs-CRP、Hcy水平。分析LVMI与各指标的相关性，采用Logistic回归方法分析影响左心室肥厚的危险因素。结果    左心室增厚组收缩压、舒张压、hs-CRP、Hcy水平均明显高于左心室正常组［（166±13）mmHg（1 mmHg=0.133 kPa）比（153±10）mmHg、（96±11）mmHg比（87±10）mmHg、（3.7±1.9）g/L比（2.6±1.3）g/L、（16.1±3.5）μmol/L比（8.8±1.6）μmol/L］，差异均有统计学意义（均P＜0.001）。相关性分析结果显示，LVMI与收缩压、舒张压、Hcy、hs-CRP均呈正相关（r=0.451，P＜0.001；r=0.493，P＜0.001；r=0.327，P=0.002；r=0.272，P=0.009）。多因素Logistic回归分析结果显示，Hcy（比值比=1.208，95%置信区间：1.019～1.419，P=0.014）与hs-CRP（比值比=1.423，95%置信区间：1.152～1.705，P=0.021）均为左心室肥厚的独立危险因素。结论    H型高血压患者LVMI与血浆Hcy和hs-CRP水平均呈正相关，Hcy和hs-CRP均是左心室肥厚的独立危险因素。

• 【Abstract】Objective    To explore the relation of plasma homocysteine(HCY) and high sensitive C-reactive protein(hs-CRP) levels with left ventricular hypertrophy in patients with H-type hypertension. Methods    A total of 137 patients with essential hypertension and hyperhomocysteinemia were enrolled from January to December 2018 in Qinghai University Affiliated Hospital. Left ventricular mass index(LVMI) was measured by echocardiography. According to LVMI, the patients were divided into left ventricular hypertrophy group(78 cases) and normal group(59 cases). Systolic blood pressure(SBP), diastolic blood pressure(DBP), serum hs-CRP and Hcy levels were detected. Correlations between LVMI and above indicators were analyzed. Risk factors of left ventricular hypertrophy were analyzed by logistic regression. Results    SBP, DBP, hs-CRP and Hcy in left ventricular hypertrophy group were significantly higher than those in normal group［（166±13）mmHg vs （153±10）mmHg, （96±11）mmHg vs （87±10）mmHg, （3.7±1.9）g/L vs （2.6±1.3）g/L, （16.1±3.5）μmol/L vs （8.8±1.6）μmol/L］(all P＜0.05). LVMI was positively correlated with SBP, DBP, hs-CRP and Hcy(r=0.451, P＜0.001； r=0.493, P＜0.001； r=0.327, P=0.002； r=0.272, P=0.009). Multivariate logistic regression showed that Hcy（odds ratio=1.208, 95% confidence interval: 1.019-1.419, P=0.014） and hs-CRP（odds ratio=1.423, 95% confidence interval: 1.152-1.705, P=0.021） were independent risk factors of left ventricular hypertrophy. Conclusions    LVMI in patients with H-type hypertension is positively correlated with serum Hcy and hs-CRP levels. Hcy and hs-CRP are independent risk factors of left ventricular hypertrophy.