【摘要】 目的 探讨老年高血压患者血清氧化三甲胺（TMAO）水平与颈动脉粥样硬化（CAS）的相关性。方法 选取2020年10月-2022年6月于承德医学院附属医院住院治疗并接受颈动脉超声检查的209例老年高血压患者作为研究对象，根据颈动脉彩超结果分为CAS组110例和NCAS组99例，比较两组临床资料。应用Pearson相关性分析血清TMAO与临床指标的关系，二元Logistic多因素回归模型分析老年高血压患者发生CAS的危险因素。应用ROC曲线预测老年高血压患者发生CAS的最佳临界值。结果 两组年龄、男性、吸烟、病程、HDL-C、LDL-C、HCY、UA、WBC、TMAO比较，差异有统计学意义（P<0.05），而两组BMI、FBG、TC、TG、LP-a比较，差异无统计学意义（P>0.05）。Pearson相关性分析显示，血清TMAO与年龄、FBG、LP-a、WBC呈正相关（r=0.302、0.150、0.213、0.145,P<0.05）。二元Logistic回归分析显示，年龄、吸烟、病程、LDL-C、WBC及TMAO均是老年高血压患者发生CAS的影响因素，HDL-C是老年高血压患者发生CAS的保护因素。ROC曲线分析显示，血清TMAO预测老年高血压患者发生CAS的曲线下面积为0.789。结论 TMAO水平升高与老年高血压患者发生CAS密切相关。更多还原

【Abstract】 Objective To investigate the correlation between serum trimethylamine oxide(TMAO) level and carotid atherosclerosis(CAS) in elderly patients with hypertension.Methods A total of 209 elderly patients with hypertension who were hospitalized in the Affiliated Hospital of Chengde Medical College from October 2020 to June 2022 and underwent carotid ultrasound examination were selected as the research objects. According to the results of carotid ultrasound, they were divided into CAS group(n =110) and NCAS group(n =99). The clinical data of the two groups were compared. Pearson correlation was used to analyze the relationship between serum TMAO and clinical indicators. Binary logistic multivariate regression model was used to analyze the risk factors of CAS in elderly patients with hypertension. ROC curve was used to predict the optimal critical value of CAS in elderly patients with hypertension.Results There were significant differences in age, male, smoking, course of disease, HDL-C, LDLC, HCY, UA, WBC and TMAO between the two groups(P<0.05), while there was no significant difference in BMI, FBG, TC, TG and LP-a between the two groups(P>0.05). Pearson correlation analysis showed that serum TMAO was positively correlated with age, FBG, LP-a and WBC( r=0.302,0.150, 0.213, 0.145, P <0.05). Binary logistic regression analysis showed that age, smoking, course of disease, LDL-C, WBC and TMAO were the influencing factors of CAS in elderly patients with hypertension, and HDL-C was the protective factor of CAS in elderly patients with hypertension.ROC curve analysis showed that the area under the curve of serum TMAO in predicting CAS in elderly patients with hypertension was 0.789.Conclusion The increase of TMAO level is closely related to CAS in elderly patients with hypertension.更多还原