摘要
目的探讨血清同型半胱氨酸(Hcy)水平与凝血功能联合检测对高血压并发动脉粥样硬化的临床诊治意义。方法选取2018年7月~2019年6月佛山市第一人民医院收治的208例高血压患者作为研究对象,其中103例患者并发有动脉粥样硬化(AS)作为高血压并发AS组,其余105例患者作为单纯高血压组,另选同期的100例健康体检者作为对照组。所有研究对象均检测血脂、血糖、Hcy和凝血功能。结果高血压并发AS组的Hcy,D-二聚体(D-Dimer)、纤维蛋白原(FIB)水平[26.02±7.44μmol/L,0.90(0.80,1.25)μg/ml,2.64±0.48g/L]均高于单纯高血压组[15.18±1.85μmol/L,0.70(0.60,0.80)μg/ml,2.57±0.42g/L](t=2.733~3.979,均P<0.05)和对照组[11.43±2.14μmol/L,0.60(0.50,0.75)μg/ml,2.66±0.45g/L](t=2.458~3.805,P=0.022);单纯高血压组血小板(PLT)水平[(241.79±56.05)×10^(9)/L]高于高血压并发AS组[(218.89±54.18)×10^(9)/L](t=2.665,P=0.008)和对照组[(226.84±55.62)×10^(9)/L](t=2.442,P=0.017)。血清Hcy与FIB(r=0.226,P=0.000),D-Dimer(r=0.201,P=0.002)呈正相关。多因素Logistic回归分析提示AS为总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和D-Dimer的影响因素;Hcy水平为FIB,D-Dimer和PLT的影响因素。结论高血压并发AS患者易发生高Hcy血症,Hcy在AS发生过程中有重要作用,同时通过影响D-Dimer,FIB,PLT水平,造成机体凝血和纤溶系统功能紊乱,进而影响高血压疾病的进展。
Objective To explore the clinical significance of combined detection of homocysteine(Hcy)and coagulation function in the diagnosis and treatment of hypertension with atherosclerosis.Methods 208 patients with hypertension admitted to the First People’s Hospital of Foshan from July 2018 to June 2019 were selected as the subjects of study.103 patients with hypertension and atherosclerosis(AS)were treated as hypertension with AS group,and the rest were treated as simple hypertension group.Another 100 cases of health examination in the same period were selected as control group,and blood glucose,Hcy and coagulation function were detectal in all subjects.Results Hcy,D-dimer and FIB levels in hypertension complicated with AS group[26.02±7.44μmol/L,0.90(0.80,1.25)μg/ml,2.64±0.48g/L]were higher than those in simple hypertension group[15.18±1.85μmol/L,0.70(0.60,0.80)μg/ml,2.57±0.42g/L](t=2.733~3.979,P<0.05)and control group[11.43±2.14μmol/L,0.60(0.50,0.75)μg/ml,2.66±0.45g/L](t=2.458~3.805,P=0.022).PLT level in hypertension group[(241.79±56.05)×10^(9)/L]was higher than that in hypertension complicated with AS group[(218.89±54.18)×10^(9)/L](t=2.665,P=0.008)and control group[(226.84±55.62)×10^(9)/L](t=2.442,P=0.017).Serum Hcy was positively correlated with FIB(r=0.226,P=0.000)and D-Dimer(r=0.201,P=0.002).Multivariate logistic regression analysis showed that AS was the influencing factor of TC,LDL-C and D-dimer,and Hcy level was the influencing factor of FIB,D-dimer and PLT.Conclusion Hypertensive patients with atherosclerosis are prone to hyper-Hcyemia.Hcy plays an important role in the process of atherosclerosis and affects the level of D-Dimer and PLT which cause the dysfunction of coagulation andfibrinolysis system and the progress of hypertension further.
作者
罗星星
郑雪莲
张瑞娴
李炜煊
LUO Xing-xing;ZHENG Xue-lian;ZHANG Rui-xian;LI Wei-xuan(Department of Clinical Laboratory,the First People’s Hospital of Foshan,Guangdong Foshan 528000,China)
出处
《现代检验医学杂志》
CAS
2021年第3期144-147,150,共5页
Journal of Modern Laboratory Medicine
