符德玉 祖亮華 辛效毅 何淑寅 劉慧銘 孔雪倩 王世紅 金露
上海中醫藥大學附屬岳陽中西醫結合醫院心內科（上海，200437，中國）
       （國家中醫藥管理局資助項目 No:04-05-JL07）
摘要 目的  初步探討高血壓患者血清同型半胱氨酸（Homocysteine， Hcy）水平與心血管危險因素的相關性。方法  檢測EH患者血清Hcy及高敏C反應蛋白（high-sensitivity C-reactive protein hs-CRP）水平，同步測量血壓、身高、體重，采集相關病史，采用相關性分析、回歸分析、方差分析、卡方檢驗對相關數據進行統計分析，初步探索血清Hcy水平與心血管危險因素的關係。結果 （1）血清Hcy水平與年齡、收縮壓（systolic blood pressure ，SBP）、hs-CRP、體重指數（body mass index BMI）、脉壓差（pulse pressure ，PP）相關。以Hcy爲因變量， SBP、舒張壓（diastolic blood pressure ，DBP）、PP爲自變量進行多重綫性回歸後入選變量爲PP（r＝0.122，P<0.01）。提示Hcy可能與年齡、炎症反應、肥胖、血管硬化等因素相關。（2）對高Hcy血症與性別、血脂异常史、高鹽飲食、缺少體力活動、吸烟、中度以上飲酒、高血壓家族史、心血管疾病家族史進行Logistic逐步回歸後入選變量爲性別，男性高血壓病患者中發生高半胱氨酸血症的概率高于女性，OR=3.660, 95%C.I:1.770~7.567。結論  EH患者血清Hcy水平與心血管危險因素中年齡、性別、hs-CRP、BMI、PP相關。
關鍵詞  原發性高血壓 同型半胱氨酸 心血管危險因素
Correlation of Homocysteine with Cardiovascular Risk Factors in Patients with Essential Hypertension: A Preliminary Study
FU Deyu ,ZU Lianghua, XIN Xiaoyi, HE Shuyin, LIU Huiming, KONG Xueqian,WANG Shihong, JIN Lu.Department of cardiovascular disease,yueyang hospital,Shanghai university of traditional Chinese medicine(Shanghai,200437,China)
Abstract  Objective  To study the correlation of serum Hcy with cardiovascular risk factors  in patients with essential hypertension. Method  Serum Hcy and hs-CRP were detected, and BP, height and weight were measured synchronously. Medical history was required in detail. And then we analyzed the data to preliminary study on the correlation of Hcy with cardiovascular risk factors by using correlation，regression, variance analysis and chi-square test..Result  (1)The serum level of Hcy correlate with age, SBP, hs-CRP, BMI and PP. Hcy was regarded as dependent variable and SBP, DBP, PP were independent variables when we performed multivariate linear stepwise regression. Through the filtration of stepwise regression, PP entered the equation (r=0.122, P<0.01). (2)The incidence of hyperhomocysteine in male is higher than that in female (OR=3.660, 95%C.I:1.770~7.567). Hcy was regarded as dependent variable and gender, history of dyslipidemia, high salt diet, lack of physical activities, smoking, drinking above moderate, family history of hypertension and heart disease were independent variables when we performed logistic forward stepwise regression and gender entered the equation. Conclusion  The serum level of Hcy corrlate with  age, gender, hs-CRP, BMI, PP in patients with essential hypertension.
Keywords  Essential Hypertension; Homocysteine; Cardiovascular risk factors