H 型高血压合并颈动脉粥样硬化患者血清Hcy 含量与炎症因子、斑块稳定性的相关性

Correlations of homocysteine with inflammatory factors and plaque stability in H-type hypertension patients combined with carotid atherosclerosis

摘要:

目的 观察H 型高血压合并颈动脉粥样硬化患者血清同型半胱氨酸（Hcy）含量变化，探讨Hcy与炎症因子、斑块稳定性的关系。方法 选取2014 年5 月-2016 年5 月在该院接受住院治疗的高血压合并颈动脉粥样硬化患者患者90 例。根据其血清Hcy 含量分为普通高血压合并颈动脉粥样硬化组（普通高血压组，Hcy<10μmol/L，n =47）、H 型高血压合并颈动脉粥样硬化组（H 型高血压组，Hcy ≥ 10μmol/L，n =43），选取同期在该院接受体检的健康人群作为对照组（n =58）。检测各组研究对象的血清Hcy、炎症因子及斑块稳定性指标含量，进一步分析Hcy 含量与炎症因子、斑块稳定性的相关性。结果 普通高血压组及H 型高血压组患者的血清Hcy、炎症因子及斑块稳定性指标含量与对照组比较，差异有统计学意义（P <0.05），其中H 型高血压组患者的血清Hcy，炎症因子人类软骨糖蛋白-3（HCGP-39）、肿瘤坏死因子-α（TNF-α）、超敏C 反应蛋白（hs-CRP）、白细胞介素-1β（IL-1β），斑块稳定性指标五聚素3（PTX3）、脂蛋白相关磷脂酶A2（Lp-PLA2）含量高于普通高血压组患者，斑块稳定性指标总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）含量低于普通高血压组患者。Pearson 线性相关分析显示，H 型高血压组患者的血清Hcy含量与炎症因子、斑块稳定性指标直接相关。结论 血清Hcy 含量升高是H 型高血压合并颈动脉粥样硬化患者全身炎症反应加剧、斑块稳定性降低的重要影响因素。

Abstract:

Objective To study the correlations of homocysteine (Hcy) with inflammatory factors and plaque stability in H-type hypertension patients combined with carotid atherosclerosis. Methods Ninety cases of H-type hypertensive patients combined with carotid atherosclerosis in our hospital from May 2014 to May 2016 were divided into ordinary hypertension with carotid atherosclerosis group (normal blood pressure group, Hcy <10 μmol/L,n = 47) and H-type hypertension with carotid atherosclerosis group (H-type hypertension group, Hcy ≥10 μmol/L, n = 43) according to serum Hcy content. A group of 58 healthy people who underwent medical examination were chosen as control group. Serum content of Hcy, inflammatory cytokines and plaque stability indices were detected. The correlations of Hcy content with inflammatory factors and plaque stability indices were further analyzed. Results Serum content of Hcy, inflammatory cytokines and plaque stability indices in the normal blood pressure group and the H-type hypertension group were significantly different from those in the control group (P < 0.05). Serum Hcy, human cartilage glycoprotein factor-39, TNF-α, hypersensitive C-reactive protein, IL-1β, pentamer 3, lipoprotein-associated phospholipase A2 in the H-type hypertension group were higher than those in the normal blood pressure group (P < 0.05); while the content of total bilirubin, direct bilirubin and indirect bilirubin in the H-type hypertension group were lower than those in the normal blood pressure group (P < 0.05). Pearson linear correlation analysis revealed that serum Hcy content in the H-type hypertension group had direct correlations with inflammatory cytokines and plaque stability indicators. Conclusions High level of Hcy is an important factor which aggravates systemic inflammatory response and reduces plaque stability in H-type hypertension patients combined with carotid atherosclerosis.