太原市4420例H型高血压病人血浆同型半胱氨酸水平及相关因素分析
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摘要
目的分析太原市4 420例H型高血压病人同型半胱氨酸(Hcy)水平及相关因素。方法以2013年3月—2017年9月就诊于太原市6家医院符合纳入和排除标准的病人为研究对象,共纳入4 420例病人,根据年龄分为6个年龄组,即<40岁组(407例)、40～<50岁组(773例)、50～<60岁组(1 395例)、60～<70岁组(1 162例)、70～<80岁组(521例)、≥80岁组(162例)。记录病人基本特征、相关病史及血浆Hcy水平,分析H型高血压病人血浆Hcy水平及相关影响因素。结果太原市H型高血压病人血浆Hcy水平为(25.83±18.60)μmol/L,男性血浆Hcy水平明显高于女性[(29.39±21.45)μmol/L与(21.39±12.97)μmol/L,P<0.001]。40岁以下病人血浆Hcy水平较40岁以上病人明显增高(P<0.05),50～<80岁病人血浆Hcy水平有升高的趋势。多元线性回归结果显示:性别、糖尿病、吸烟、脑卒中家族史是H型高血压病人血浆Hcy水平的相关因素(P<0.001)。结论太原市H型高血压病人血浆Hcy水平显著高于我国成年H型高血压病人血浆Hcy平均水平,性别、糖尿病、吸烟、脑卒中家族史是H型高血压病人血浆Hcy的相关因素。
Objective To analyze the level of homocysteine(Hcy) and related factors in 4 420 patients with type H hypertension in Taiyuan City.Methods Patients admitted to 6 hospitals from March 2013 to September 2017 in Taiyuan City who met the inclusion and exclusion criteria were included in the study.A total of 4 420 patients were included,and divided into 6 groups according to age:<40 years old group(407 cases),40 to <50 years old group(773 cases),50 to <60 years old group(1 395 cases),60 to <70 years old group(1 162 cases),70 to <80 years old group(521 cases),and ≥80 years old group(162 cases).The basic characteristics of patients,related medical history,and plasma Hcy level were recorded.The plasma Hcy level and related factors were analyzed in patients with type H hypertension.Results The plasma Hcy level of type H hypertensive patients in Taiyuan City was(25.83±18.60) μmol/L,and the plasma Hcy level of males was significantly higher than that of female [(29.39±21.45)μmol/L vs(21.39±12.97) μmol/L,P<0.001].The plasma Hcy level of patients under 40 years old was significantly higher than that of patients over 40 years old(P<0.05).The plasma Hcy level of patients aged 50-80 years old tended to increase.Multiple linear regression results showed that gender,diabetes,smoking,and family history of stroke were related factors of plasma Hcy levels in patients with type H hypertension(P<0.001).Conclusion The plasma Hcy level in Taiyuan City is significantly higher than the average level of plasma Hcy in adult type H hypertensive patients.Gender,diabetes,smoking,and family history of stroke are related factors of plasma Hcy in patients with type H hypertension.
Objective To analyze the level of homocysteine(Hcy) and related factors in 4 420 patients with type H hypertension in Taiyuan City.Methods Patients admitted to 6 hospitals from March 2013 to September 2017 in Taiyuan City who met the inclusion and exclusion criteria were included in the study.A total of 4 420 patients were included,and divided into 6 groups according to age:<40 years old group(407 cases),40 to <50 years old group(773 cases),50 to <60 years old group(1 395 cases),60 to <70 years old group(1 162 cases),70 to <80 years old group(521 cases),and ≥80 years old group(162 cases).The basic characteristics of patients,related medical history,and plasma Hcy level were recorded.The plasma Hcy level and related factors were analyzed in patients with type H hypertension.Results The plasma Hcy level of type H hypertensive patients in Taiyuan City was(25.83±18.60) μmol/L,and the plasma Hcy level of males was significantly higher than that of female [(29.39±21.45)μmol/L vs(21.39±12.97) μmol/L,P<0.001].The plasma Hcy level of patients under 40 years old was significantly higher than that of patients over 40 years old(P<0.05).The plasma Hcy level of patients aged 50-80 years old tended to increase.Multiple linear regression results showed that gender,diabetes,smoking,and family history of stroke were related factors of plasma Hcy levels in patients with type H hypertension(P<0.001).Conclusion The plasma Hcy level in Taiyuan City is significantly higher than the average level of plasma Hcy in adult type H hypertensive patients.Gender,diabetes,smoking,and family history of stroke are related factors of plasma Hcy in patients with type H hypertension.
引文
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[13] 庞鸿瑞,张景玉,徐上知,等.新疆哈萨克族人血清同型半胱氨酸分布特征及高同型半胱氨酸血症流行特征[J].中国循环杂志,2014,29(11):913-916.
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[15] TESSARI P,CECCHET D,VETTORE M,et al.Decreased homocysteine trans-sulfuration in hypertension with hyperhomocysteinemia:relationship with insulin resistnce[J].J Clin Endocrinol Metab,2018,103(1):56-63.
[16] LI J,JIANG S,ZHANG Y,et al.H-type hypertension and risk of stroke in Chinese adults:a prospective,nested case-control study[J].J Transl Int Med,2015,3(4):171-178.
[17] ZHAO D,LIU J,WANG W,et al.Epidemiological transition of stroke in China:twenty-one-year observational study from the Sino-MONICA-Beijing project[J].Stroke,2008,39(6):1668-1674.
[18] HUO Y,LI J,QIN X,et al.Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China:the CSPPT randomized clinical trial[J].JAMA,2015,313(13):1325-1335.
[2] 李建平,卢新证,霍勇,等.H型高血压诊断与治疗专家共识[J].中华高血压杂志,2016,24(2):123-127.
[3] WANG C Y,CHEN Z W,ZHANG T,et al.Elevated plasma homocysteine level is associated with ischemic stroke in Chinese hypertensive patients[J].Eur J Intern Med,2014,25(6):538-544.
[4] SACCO R L,ADAMS R,ALBERS G,et al.Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack:a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke:Co-sponsored by the Council on Cardiovascular Radiology and Intervention:the American Academy of Neurology affirms the value of this guideline [J].Circulation,2006,113(10):409-449.
[5] 胡大一,徐希平.有效控制“H型”高血压——预防卒中的新思路[J].中华内科杂志,2008,47(12):976-977.
[6] SUN Y,CHIEN K L,HSU H C,et al.Use of serum homocysteine to predict stroke,coronary heart disease and death in ethnic Chinese.12-year prospective cohort study[J].Circ J,2009,73(8):1423-1430.
[7] 李建平,霍勇,刘平,等.马来酸依那普利叶酸片降压、降同型半胱氨酸的疗效和安全性[J].北京大学学报(医学版),2007,39(6):614-618.
[8] TOWFIGHI A,MARKOVIC D,OVBIAGELE B.Pronounced association of elevated serum homocysteine with stroke in subgroups of individuals:a nationwide study[J].Neurol Sci,2010,298(1):153-157.
[9] 中国高血压防治指南修订委员会.中国高血压防治指南[J].中华高血压杂志,2011,19(8):701-743.
[10] 张明玺,罗俊.H型高血压的病因及发病机制[J].心血管病进展,2012,33(2):253-256.
[11] GANGULY P,ALAM S F.Role of homocysteine in the development of cardiovascular disease[J].Nutr J,2015,14(1):1-18.
[12] 李萌,周欢琴,万晓晨.杭州地区部分人群血清同型半胱氨酸及血脂水平的调查研究[J].中国卫生检验杂志,2013,23(6):1579-1581.
[13] 庞鸿瑞,张景玉,徐上知,等.新疆哈萨克族人血清同型半胱氨酸分布特征及高同型半胱氨酸血症流行特征[J].中国循环杂志,2014,29(11):913-916.
[14] UNVERDORBEN M,VON HOLT K,WINKELMAN B R.Somking and atherosclerotic cardiovascular disease:Part Ⅱ:role of cigarette smoking in cardiovascular disease development[J].Biomark Med,2009,3(5):617-653.
[15] TESSARI P,CECCHET D,VETTORE M,et al.Decreased homocysteine trans-sulfuration in hypertension with hyperhomocysteinemia:relationship with insulin resistnce[J].J Clin Endocrinol Metab,2018,103(1):56-63.
[16] LI J,JIANG S,ZHANG Y,et al.H-type hypertension and risk of stroke in Chinese adults:a prospective,nested case-control study[J].J Transl Int Med,2015,3(4):171-178.
[17] ZHAO D,LIU J,WANG W,et al.Epidemiological transition of stroke in China:twenty-one-year observational study from the Sino-MONICA-Beijing project[J].Stroke,2008,39(6):1668-1674.
[18] HUO Y,LI J,QIN X,et al.Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China:the CSPPT randomized clinical trial[J].JAMA,2015,313(13):1325-1335.