| 韩萌,习玲,陈李娟.血清同型半胱氨酸、尿酸、血清胱抑素对中老年人原发性高血压合并左心室肥厚的影响[J].中国临床保健杂志,2023,26(3):367-370. |
| 血清同型半胱氨酸、尿酸、血清胱抑素对中老年人原发性高血压合并左心室肥厚的影响 |
| A study on the correlation between serum Hcy,UA,Cys and primary hypertension with left ventricular hypertrophy in the middle aged and elderly patients |
| 投稿时间：2022-04-07 |
| DOI：10.3969/J.issn.1672-6790.2023.03.018 |
| 中文关键词: 原发性高血压 心肌病,肥厚性 半胱氨酸 尿酸 |
| 英文关键词: Essential hypertension Cardiomyopathy,hypertrophic Cysteine Uric acid 〖FL |
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| 中文摘要: |
| 目的 探讨血清同型半胱氨酸(Hcy)、尿酸(UA)、血清胱抑素(Cys)与中老年人原发性高血压患者左心室肥厚的关系。方法 收集2016年9月至2019年9月在山西医科大学第一医院诊治的原发性高血压患者342例。详细记录患者性别、年龄、血压分级、病程、家族史、身高、体重、Hcy、UA、Cys及其他生化指标。回顾超声心动图检查并计算出左心室质量指数(LVMI),根据超声心动图诊断左心室肥厚标准,将所有患者分为左心室肥厚组(HLVM组,107例)和非左心室肥厚组(NLVM组,235例)。统计学分析组间患者临床指标的差异、原发性高血压合并左心室肥厚的独立危险因素及血液生化指标判断左心室肥厚的价值。结果 不同组间患者的性别、血压分级、吸烟史、家族史、病程、体重指数(BMI)、肌酐(Cr)、尿素氮(BUN)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、舒张压(DBP)差异无统计学意义(P>0.05),而年龄、UA、Cys、Hcy、左心室射血分数(LVEF)、收缩压(SBP)、脉压差异显著,差异有统计学意义(P<0.05)。二元logistic回归结果显示UA、Cys、Hcy、LVEF、脉压是左心室肥厚的独立因素。UA、Cys、Hcy诊断左心室肥厚的ROC曲线下面积分别为0.633、0.660、0.687,3个指标联合诊断左心室肥厚的ROC曲线下面积为0.726。结论 血清UA、Cys、Hcy是原发性高血压合并左心室肥厚的独立危险因素。与UA、Cys相比,Hcy在判断原发性高血压合并左心室肥厚中的价值更高。与单个指标相比,3个指标联合判断原发性高血压合并左心室肥厚的价值最高。 |
| 英文摘要: |
| Objective To investigate the relationship between serum homocysteine (Hcy),uric acid (UA),serum cystatin (Cys) and primary hypertension with left ventricular hypertrophy in the middle aged and elderly patients.Methods A total of 342 patients with primary hypertension diagnosed and treated in the first hospital of Shanxi Medical University from September 2016 to September 2019 were collected.The patient′s clinical data,including gender,age,blood pressure grade,course of diseases,family history,height,weight,Hcy,UA,Cys and other biochemical indicators,were recorded.Left ventricular mass index (LVMI) was calculated according to the relevant data in echocardiography.All patients were divided into left ventricular hypertrophy group (HLVM group,n=107) and non-left ventricular hypertrophy group (NLVM group,n=235) according to echocardiographic criteria for diagnosis of left ventricular hypertrophy.Statistical analyses of the difference in clinical indicators between the two groups,the independent risk factors of primary hypertension with left ventricular hypertrophy and the value of blood biochemical indicators to determine left ventricular hypertrophy were done.Results Among different groups,there was no significant difference in gender,blood pressure grade,smoking history,family history,course of disease,BMI,Cr,BUN,FBG,HDL-C,LDL-C,TG,TC and DBP (P>0.05).but there were significant differences in age,UA,Cys,Hcy,LVEF,SBP and pulse pressure (P<0.05).Logistic regression showed that UA,Cys,Hcy,LVEF and pulse pressure were the independent factors of left ventricular hypertrophy.The area under ROC of UA,Cys and Hcy in the diagnosis of left ventricular hypertrophy was 0.633,0.660 and 0.687,respectively.The area under ROC of the joint value of three indexes in the diagnosis of left ventricular hypertrophy was 0.726.Conclusions Serum UA,Cys and Hcy are the independent risk factors of primary hypertension with left ventricular hypertrophy.Compared with UA and Cys,Hcy has a higher value in judging left ventricular hypertrophy.Compared with a single index,the combination of the three indexes has the highest value in judging left ventricular hypertrophy. |
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