【摘要】：目的:探討青海地區(qū)藏、漢族H型高血壓患者頸動(dòng)脈內(nèi)中膜厚度(CIMT)、血管內(nèi)皮功能(FMD)、血漿同型半胱氨酸(Hcy)間的相互關(guān)系,通過(guò)比較所采集的藏、漢族H型高血壓患者CIMT、FMD和Hcy水平,用統(tǒng)計(jì)學(xué)方法來(lái)比較相對(duì)應(yīng)指標(biāo)之間是否具有差異性及其相關(guān)性。方法:收集高血壓病人共計(jì)131人,漢族85人,藏族46人。所入選病例均行頸動(dòng)脈超聲檢查,測(cè)定CIMT值即在頸總動(dòng)脈分叉處近端lcm測(cè)量CIMT值3次的平均值作為最終記錄值。采用高分辨力超聲檢測(cè)血管內(nèi)皮功能的方法,檢測(cè)FMD。測(cè)定血漿Hcy水平時(shí)采用循環(huán)酶的方法(由同一人檢測(cè))。結(jié)果:(1)本次收集各組病例的年齡、病史、BPM、DPM、TC、TG、LDL、HDL均無(wú)統(tǒng)計(jì)學(xué)差異。(2)不同型高血壓患者,漢族不同類(lèi)型高血壓CIMT、FMD、血漿Hcy均有統(tǒng)計(jì)學(xué)差異(P0.05),其中CIMT及血漿Hcy平均值漢族H型高血壓組高于非H型高血壓組,FMD平均值前者低于后者;藏族不同類(lèi)型高血壓FMD、血漿Hcy比較有統(tǒng)計(jì)學(xué)差異,H型高血壓組血漿Hcy平均水平高于非H型高血壓組,FMD平均值前者平均值低于后者;藏、漢族非H高血壓組比較,FMD比較有統(tǒng)計(jì)學(xué)差異(P0.05),并且前者平均值低于后者平均值;藏、漢族H型高血壓組比較,血漿Hcy有統(tǒng)計(jì)學(xué)差異(P0.05),前者平均值高于后者。(3)漢族非H型高血壓患者CIMT、FMD、血漿Hcy與可能相關(guān)因素?zé)o相關(guān)。(4)藏、漢族H型高血壓CIMT跟年齡、血漿Hcy呈正相關(guān);與FMD呈負(fù)相關(guān);與病史無(wú)相關(guān);FMD與血漿Hcy、CIMT呈負(fù)相關(guān),與病史均無(wú)相關(guān),漢族H型高血壓FMD和年齡呈負(fù)相關(guān);血漿Hcy與FMD呈負(fù)相關(guān),與CIMT呈正相關(guān),與年齡無(wú)相關(guān)。(5)藏族非H型高血壓患者CIMT和病史、FMD、血漿Hcy相關(guān),與其它指標(biāo)均無(wú)相關(guān)。結(jié)論:(1)青海地區(qū)藏漢族H型高血壓患者間CIMT、FMD未見(jiàn)民族不同,但在血漿Hcy水平上存在民族差異性;(2)藏、漢族H型高血壓患者血漿Hcy和FMD、CIMT存在相關(guān)性,在FMD方面的相關(guān)因素中存在不同。
[Abstract]:Objective: to investigate the relationship between carotid intima-media thickness (CIMT),) endothelial function (FMD),) and plasma homocysteine (Hcy) (Hcy) in patients with H type hypertension in Qinghai and Han nationality, and to compare the CIMT,FMD and Hcy levels in patients with H type hypertension. The statistical method was used to compare the difference and correlation between the corresponding indicators. Methods: a total of 131 patients with hypertension were collected, 85 of Han nationality and 46 of Tibetan nationality. All the patients were examined by carotid ultrasound. The CIMT value was measured by lcm at the proximal end of the common carotid artery as the final recorded value. High resolution ultrasound was used to detect vascular endothelial function and FMD. was detected. The level of plasma Hcy was measured by circulating enzyme method (detected by the same person). Results: (1) there was no significant difference in age, history and BPM,DPM,TC,TG,LDL,HDL among the three groups. (2) there was no significant difference in age, history and BPM,DPM,TC,TG,LDL,HDL among the patients with different types of hypertension. There were significant differences in plasma Hcy between different types of hypertension in Han nationality (P0.05). The mean value of CIMT and plasma Hcy in H type hypertension group was higher than that in non H type hypertension group, and FMD average value in the former group was lower than that in the latter group. The average level of plasma Hcy in H type hypertension group was higher than that in non H type hypertension group, and the FMD average value in the former was lower than that in the latter group. There was significant difference in FMD between Han nationality and non-H hypertension group (P0.05), and the average value of the former was lower than that of the latter, while that of Tibetan and Han patients with H type hypertension was lower than that of the latter. There was significant difference in plasma Hcy (P0.05), the former was higher than that of the latter. (3) there was no correlation between plasma Hcy and possible related factors in Han non-H hypertension patients. (4) in Han nationality, CIMT of H type hypertension was positively correlated with age, plasma Hcy was positively correlated with FMD, and negatively correlated with FMD. There was no correlation between FMD and history, no correlation between FMD and plasma Hcy,CIMT, and negative correlation between FMD and age in patients with H type hypertension in Han nationality, and there was a positive correlation between plasma Hcy and FMD and CIMT. There was no correlation between age and age. (5) there was no correlation between CIMT, history, FMD, plasma Hcy and other indexes in Tibetan patients with non-H hypertension. Conclusion: (1) there is no difference in CIMT,FMD between H type hypertension patients of Tibetan and Han nationality in Qinghai area, but there is a national difference in plasma Hcy level, (2) there is a correlation between plasma Hcy and FMD,CIMT in Tibetan and Han nationality patients with H type hypertension. There are differences in FMD related factors.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R544.1

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