摘要
目的探讨合并2型糖尿病对于高血压患者的血浆同型半胱氨酸(Hcy)、踝臂指数(ABI)的影响。方法选择2014年12月至2015年9月期间就诊于山西医科大学第二医院心内科及内分泌科的首次发现的高血压患者,根据合并糖尿病的详细情况,将首次发现的高血压患者120例分为两组:单纯高血压组(60例)和合并2型糖尿病的高血压组(合并组,60例),此外选择年龄、性别相匹配的正常体检者30例作为健康对照组,分别测定其空腹血糖(GLU)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、C反应蛋白(CRP)、血浆Hcy和ABI,并用Logistic多元回归法分析多因素对ABI的影响。结果 (1)健康对照组、高血压组、合并组的HDL-C均非常接近,差异无统计学意义(P>0.05),而3组的TC、TG、LDL-C、UA水平差异均有统计学意义(P<0.05)。合并组的CRP高于单纯高血压组,且差异有统计学意义(P<0.05)。(2)单纯高血压组和合并组的血浆Hcy水平均较健康对照组增高[(16.54±1.44)μmol/L,(19.87±4.76)μmol/L vs.(12.98±4.10)μmol/L],差异有统计学意义(P<0.05);合并组的血浆Hcy水平高于单纯高血压组,差异有统计学意义(P<0.05)。单纯高血压组和合并组的ABI水平较健康对照组减低(1.03±0.15,0.82±0.17 vs.1.17±0.08,P<0.05);合并组的ABI水平低于单纯高血压组,且差异有统计学意义(P<0.05)。(3)血浆Hcy与ABI呈负相关,相关系数为-0.533(P<0.001)。(4)Logistic多元回归分析结果显示,GLU、TC、LDL-C、Hcy均是动脉硬化发生发展的危险因素。结论血浆Hcy升高及ABI下降是高血压患者动脉硬化发生发展的危险因素,且合并2型糖尿病会使原发性高血压患者的血浆Hcy水平更高,且动脉硬化程度加重,表现为ABI进一步减低。
Objective To discuss the influence of hypertension with diabetes mellitus on homocysteine(Hcy) and ankle brachial index(ABI). Methods One hundred and twenty cases of hypertension who had been found in a first time were divided into two groups: simple hypertension group(n=60) and hypertension with diabetes mellitus group(n=60). 30 cases of healthy individuals were chosen as matched group, the blood glucose(GLU), blood lipid, blood uric acid(UA), C-reactive protein(CRP), Hcy and ABI were measured respectively, and their correlations were analyzed. Results(1) The high density lipoprotein-cholesterol(HDL-C) in the hypertension group and the combined group were close, the difference was not statistically significant(P>0.05). But the differences of total cholesterol(TC), triglycerides(TG), LDL-C, UA level of the three groups had statistical significance. The CRP of the combined group were higher than that of the hypertension group, the difference was statistically significant(P<0.05).(2) Compared with the matched group, the Hcy [(16.54±1.44) μmol/L,(19.87±4.76) μmol/L vs.(12.98±4.10) μmol/L] of the other groups were significantly increased, and ABI level(1.03±0.15, 0.82±0.17 vs. 1.17±0.08, P<0.05) were all reduced.(3) Hcy was negatively correlated with ABI(r=-0.533, P<0.001).(4) Logistic regression analysis showed that TC, low-density lipoprotein cholesterol(LDL-C), GLU and Hcy were related independently with arterial sclerosis. Conclusions It is further confirmed that Hcy is a risk factor for the occurrence and development of atherosclerosis in patients with hypertension. Combined with type 2 diabetes increases the Hcy levels of patients with hypertension and aggravates the degree of arteriosclerosis, which shows a decrease of ABI.
出处
《中华临床医师杂志（电子版）》
CAS
2017年第2期183-187,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
高半胱氨酸
高血压
踝臂指数
糖尿病
Homocysteine
Hypertension
Ankle brachial index
Diabetes mellitus
