【摘要】 目的:研究同型半胱氨酸(Hcy)水平与高血压痛患者颈动脉斑块形成的相关性。方法:161例高血压痛患者分别检测Hcy、血脂(甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白)、血尿酸、肺炎衣原体抗体(Cpn-IgG)等指标,以高频超声确定患者颈动脉斑块的有无。依斑块的有无进行分组,对比两组间Hcy、血脂、血尿酸、年龄、体重指数(BMI)的差异和对比糖尿病、血脂异常、吸烟的发生率,男性比率、Cpn-IgG的阳性率在两组间的差异。采用Logistic分析方法确定高血压患者颈动脉发生斑块的危险因素。结果:在斑块无和有两组间,Hcy存在明显的差异(15．8±10．9 vs 20．6±10．4μmol／L, P<0．05);而年龄(59．3±11．4 vs 68．1±9．5岁,P<0．001)、吸烟的比例(25．3％vs 52．9％,P<0．001)、男性的比例(47．3％vs 75．7％,P<0．001)在两组间也存在显著差异。而其它因素,包括血脂、尿酸、血糖、血脂异常发生率、糖尿痛发生率、Cpn-IgG阳性率在两组间均无显著差异。Logistic逐步回归分析显示:吸烟(P<0．001)和年龄(P<0．001)是高血压痛患者颈动脉发生斑块与否的独立危险因素,两者的相对危险度和95％可信区间分别为4．916(2．234-10．820)和1．125 (1．073-1．178)。结论:吸烟和年龄是高血压病患者颈动脉发生动脉粥样硬化斑块的独立危险因素,而Hcy为非独立因素。更多还原

【Abstract】 Objective:To explore the relationship between plasma homocysteine(Hcy) level and common carotid athersclerosis in patients with essential hypertension. Methods; 161 patients with essential hypertension were recuited and their common carotid athersclerosis (AS) were measured by high resolved liner array transducer. At the same time their blood specimens were collected for determining the levels of Hcy,serum lipid,uric acid,serum IgG of Chlamydia pneumonia ect . and body mass index (BMI) were assessed as well. Compared the difference of all the factors between the group of AS and no-AS. Multiple factors analysis was also made with Logistic regression analysis. Results:There were singnificant differences in Hcy (15. 8±10. 9 vs 20. 6±10.4μmol/L,P<0.05), age (59.3±11.4 vs 68.1±9. 5 years,P<0.001), the rates of smoking(25.3%vs 52.9% ,P< 0. 001)and the rates of male(47.3%vs75.7% ,P<0. 001)between the two groups(no-ASvsAS). No difference in the other factors between the two groups were fonud. Multiple logistic regression model indicated that smoking and age were the independent factors of AS. The odds ratio (OR)and 95% confidence intenral(95%CI) were 4. 916(2. 234-10. 820) (smoking) and 1.125(1.073-1.178), age respectively. Conclusion:Smoking and age are the independent risk factors of AS in patients with essential hypertension. Hcy is not a independent factor.更多还原