摘要
目的研究原发性高血压患者血浆同型半胱氨酸(Hcy)与肱动脉血流介导的内皮依赖性血管舒张功能(FMD)的关系。方法选择单纯高血压患者62例、高血压合并高同型半胱氨酸血症(H型高血压)患者61例及健康体检者30名,采用无创性高分辨超声技术检测3组休息、反应性充血后肱动脉内径的变化。采用循环酶法检测血浆Hcy水平。结果单纯高血压组、H型高血压组FMD均低于对照组(P<0.05),H型高血压组FMD最低(P<0.05);直线相关分析显示,Hcy与FMD呈负相关(r=-0.607,P<0.01);校正年龄、性别、Hcy、收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等因素后,Logistic回归分析发现Hcy、SBP、DBP为FMD的影响因素(均P<0.05)。结论原发性高血压患者血浆Hcy与FMD呈负相关,Hcy可能参与了原发性高血压患者内皮功能障碍的发生与发展。
Objective To investigate the association of plasma homocysteine （Hey） with flow mediated en dothelium dependent vasodilation（FMD） in patients with essential hypertension. Methods With high-resolution ultrasonography,the diameter of brachial arteries at rest,during reactive hyperaemia were detected in 153 subjects including 62 cases of essential hypertension,61 cases of essential hypertension patients with hyper homocysteinemia and 30 cases normal control. Plasma homocysteine levels were assayed by enzymatic cycling method. Results Compared with the normal control group,FMDs in the group of essential hypertension and essential hypertension patients with hyper homocysteinemia significantly reduced （P〈0.05）, especially in the essential hypertension patients with hyper homocysteinemia （P〈0.05）. Conclusion Plasma homocysteine was negatively correlated with endothelial dysfunction in patients with essential hypertension, suggesting that plasma homocysteine might impair endothelium-dependent vasodilation.
