本文選題：原發(fā)性高血壓 + 同型半胱氨酸��； 參考：《安徽醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的：本課題主要觀察原發(fā)性高血壓(essential hypertension, EH)患者人群中血漿同型半胱氨酸(homocysteine, Hcy)、高敏C反應(yīng)蛋白(high-sensitivity C-reactive protein, hsCRP)的含量,以及動(dòng)態(tài)血壓變異性(blood pressure variability, BPV),以探討其與頸動(dòng)脈內(nèi)膜中層厚度(carotid intima-media thickness, cIMT)之間的相互關(guān)系。方法：選取2014年1月至2014年12月入住安徽省立醫(yī)院心血管內(nèi)科的確診為EH患者215例。其中包括124例男性,91例女性。這些患者年齡分布在27歲到86歲,平均年齡62±11歲,依據(jù)頸動(dòng)脈超聲檢查結(jié)果,將入選病例分為三組,IMT正常組、IMT增厚組、斑塊組。納入IMT正常組69名患者,其中.37名男性,32名女性,平均年齡61±11歲；納入IMT增厚組74名患者,其中44名男性,30名女性,平均年齡61±11歲；納入斑塊組72名患者,其中43名男性,29名女性,平均年齡65±10歲。給予所有患者行血漿一般生化檢查：血總膽固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low-density lipoprotein cholesterol, LDL-C)、血肌酐(serum creatinine, SCr);并行血漿Hcy, hsCRP檢查,使用動(dòng)態(tài)血壓監(jiān)測(ambulatory blood pressure monitoring, ABPM)得反映BPV參數(shù)：24小時(shí)收縮壓標(biāo)準(zhǔn)差(24hour systolic blood pressure standard deviation,24hSSD)、24小時(shí)舒張壓標(biāo)準(zhǔn)差(24hour diastolic blood pressure standard deviation,24hDSD)、日間收縮壓標(biāo)準(zhǔn)差(day systolic blood pressure s tandard dev i at i on, dSSD)、夜間收縮壓標(biāo)準(zhǔn)差(night systolic blood pressure standard deviation, nSSD)、日間舒張壓標(biāo)準(zhǔn)差(day diastolic blood pressurestandard deviation, dDSD)、夜間舒張壓標(biāo)準(zhǔn)差(night diastolic blood pressure standard deviation, nDSD),進(jìn)行統(tǒng)計(jì)學(xué)分析,以評價(jià)Hcy、hsCRP和BPV的相關(guān)指標(biāo)與cIMT之間的相關(guān)性。結(jié)果：在年齡、性別、TC、TG、HDL-C、LDL-C、SCr指標(biāo)的比較上,三組患者之間沒有統(tǒng)計(jì)學(xué)差異(P0.05),提示三組之間具有可比性；三組間的hsCRP和Hcy水平存在統(tǒng)計(jì)學(xué)差異(P0.01),其中斑塊組、IMT增厚組與IMT正常組比較hsCRP和Hcy水平明顯增加,斑塊組hsCRP和Hcy水平比IMT增厚組明顯增高;三組間24hSSD、dSSD、nSSD水平有明顯的統(tǒng)計(jì)學(xué)差異(P0.01),其中斑塊組、IMT增厚組與IMT正常組比較24hSSD、dSSD、nSSD水平明顯增加,斑塊組24hSSD、dSSD、 nSSD水平比IMT增厚組明顯增高；線性相關(guān)分析提示：IMT與hsCRP、Hey、24hSSD、 dSSD、nSSD、 nDSD之間存在顯著正相關(guān),r值分別為0.643、0.732、0.407、0.522、0.538、0.180(均P0.01)結(jié)論：1.在EH患者中,頸動(dòng)脈粥樣硬化(carotid atherosclerosis,CAS)的程度越重,hsCRP、Hcy水平以及收縮壓的變異性(24hSSD、dSSD、nSSD)越高；2.在EH患者中,cIMT與hsCRP、Hcy、24hSSD、dSSD、nSSD、nDSD之間存在顯著正相關(guān)。
[Abstract]:Objective: to observe the plasma homocysteine (Hcy), Gao Min C-reactive protein high-sensitivity C-reactive protein (hsCRP-) in patients with essential hypertension (EH). The relationship between blood pressure variability and carotid intima-media thickness carotid intima-media thicknesswas studied. Methods: 215 EH patients admitted to Anhui Provincial Hospital from January 2014 to December 2014 were selected. Among them, 124 cases were male and 91 cases were female. The age of these patients ranged from 27 to 86 years old, with an average age of 62 鹵11 years. According to the results of carotid ultrasound, the patients were divided into three groups: IMT thickening group and plaque group. There were 69 patients in the normal IMT group, including .37 males and 32 females with an average age of 61 鹵11 years, 74 patients in the IMT thickening group, including 44 males and 30 females with an average age of 61 鹵11 years, and 72 patients in the plaque group. There were 43 males and 29 females with an average age of 65 鹵10 years. All patients were given plasma general biochemical tests: total cholesterol, TCU, triglyceride, TGN, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, LDL-CU, serum creatinine, serum hcy, hsCRP. Using ambulatory blood pressure monitoring (ABPM) blood pressure monitoring, ABPM) to reflect the BPV parameters: 24 hour systolic blood pressure standard deviation and 24 hour systolic blood pressure standard deviation, 24 hour diastolic blood pressure standard deviation, day to day systolic blood pressure s tandard dev i at i on, dSSDD, nighttime DBP standard deviation, 24 hour DBP standard deviation and 24 hour DBP standard deviation, day to day systolic blood pressure standard deviation. The standard deviation of systolic blood pressure (night), day diastolic blood pressure (DBP), night diastolic blood pressure (DBP) and night diastolic blood pressure (DBP) were analyzed statistically. To evaluate the correlation between hsCRP and BPV and cIMT. Results: there was no statistical difference between the three groups in the age, sex and HDL-CU LDL-Cr, suggesting that there was comparability among the three groups. There were significant differences in hsCRP and Hcy levels among the three groups (P 0.01). The hsCRP and Hcy levels in the plaque group were significantly higher than those in the normal IMT group, and the hsCRP and Hcy levels in the plaque group were significantly higher than those in the IMT thickening group. There was significant statistical difference among the three groups in 24 h SSDD dSSDnSSD levels. The level of SSDD dSSDnSSD in the plaque group was significantly higher than that in the normal IMT group at 24 h, and the nSSD level in the plaque group was significantly higher than that in the IMT thickening group. The linear correlation analysis showed that there were significant positive correlation r values between nDSD and hsCRPnSSD24hSSD, dSSD-nSSDand nDSD, respectively. Conclusion: 1. In EH patients, the higher the degree of carotid atherosclerosis carotid atherosclysis (CAS) was, the higher the Hcy level of hsCRP and the variability of systolic blood pressure were 24 h SSDD SSDnSSDnSSD2. In EH patients, there was a significant positive correlation between cIMT and 24 h SSDN dSSDN nSSDnDSD.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R544.1

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