【摘要】：目的:根據(jù)原發(fā)性高血壓(EH)伴左心室肥厚(LVH)病患的血清同型半胱氨酸(Hcy)值及心律失常程度的結(jié)果,探究血清Hcy的濃度、心律失常與左心室肥厚是否有關(guān)聯(lián),為EH伴左心室肥厚患者控制病情進(jìn)程及早期干預(yù)提供可靠的理論依據(jù)。方法:依據(jù)納入、各項(xiàng)排除標(biāo)準(zhǔn),選取年齡段在45歲-70歲之間的EH患者80例(EH組),其中包含LVH組(40例)和不伴L(zhǎng)VH組(40例),此外采選40例身體狀況良好的人員設(shè)為對(duì)照組。分別對(duì)120例實(shí)驗(yàn)對(duì)象做如下處理:(1)記錄下3次血壓(BP)平均值、吸煙史、性別、身高、體重、年齡,計(jì)算出BMI數(shù)值;(2)抽取少量空腹靜脈血,檢測(cè)Hcy、LDL、HDL、TG、TC水平;(3)使用彩色多普勒超聲探測(cè)儀測(cè)量心臟結(jié)構(gòu),計(jì)算出左心室質(zhì)量指數(shù);(4)行24小時(shí)動(dòng)態(tài)心電監(jiān)護(hù)記錄心電變化,根據(jù)Kleiger、Lown分級(jí)方法統(tǒng)計(jì)心律失常的結(jié)果。根據(jù)三組研究對(duì)象的心律異常情況、血清Hcy濃度的對(duì)比結(jié)果,分析探討這兩者與EH伴左室肥厚有無(wú)關(guān)聯(lián)。應(yīng)用SPSS18.0進(jìn)行數(shù)據(jù)的統(tǒng)計(jì)分析。結(jié)果:三組Hcy濃度的比較:(1)LVH組不伴L(zhǎng)VH組健康對(duì)照組,組間相比后的差別都具備統(tǒng)計(jì)學(xué)意義P0.05。三組心律失常情況的比較:(1)總房性心律失常的差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(2)總室性心律失常、Kleiger及Lown分級(jí)≥3級(jí)中,肥厚組分別與不伴肥厚組及健康組的差異,符合統(tǒng)計(jì)學(xué)意義P0.05,不伴L(zhǎng)HV與健康組之間的差別,無(wú)統(tǒng)計(jì)學(xué)意義P0.05。結(jié)論:從實(shí)驗(yàn)數(shù)據(jù)的結(jié)果中可以分析出:血清Hcy濃度、心律失常程度與LVH具有關(guān)聯(lián)性。除去其他已知的LVH風(fēng)險(xiǎn)因子,Hcy濃度升高成為新晉的一員。LVH又是觸發(fā)心律異常風(fēng)險(xiǎn)產(chǎn)生的緊要緣由之一。
[Abstract]:Objective: based on the results of serum homocysteine (Hcy) and degree of arrhythmia in patients with essential hypertension (EH) and left ventricular hypertrophy (LVH), to explore the relationship between serum Hcy concentration, arrhythmia and left ventricular hypertrophy. To provide reliable theoretical basis for EH patients with left ventricular hypertrophy to control the disease progression and early intervention. Methods: according to the inclusion and exclusion criteria, 80 patients with EH between 45 and 70 years old (EH group) were selected, including LVH group (40 cases) and non-LVH group (40 cases). In addition, 40 healthy persons were selected as control group. 120 subjects were treated as follows: (1) three times of blood pressure (BP) mean, smoking history, sex, height, weight, age, calculated BMI value; (2) a small amount of fasting venous blood was taken to detect the level of Hcy,LDL,HDL,TG,TC, (3) the structure of the heart was measured by color Doppler ultrasound, and the left ventricular mass index was calculated. (4) ECG changes were recorded by 24 hours dynamic ECG monitoring, and the results of arrhythmia were calculated according to Kleiger,Lown classification method. According to the arrhythmia of the three groups and the comparison of serum Hcy concentration, the relationship between them and EH with left ventricular hypertrophy was analyzed. SPSS18.0 is used to analyze the data. Results: (1) the difference of Hcy concentration between LVH group and LVH group was statistically significant (P 0.05). Comparison of arrhythmia in the three groups: (1) the difference of total atrial arrhythmia was not statistically significant (P0.05); (2) in total ventricular arrhythmia, Kleiger and Lown grade 鈮，

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