老年男性高血压患者中左室肥厚与代谢指标相关性的研究-现代医学

老年男性高血压患者中左室肥厚与代谢指标相关性的研究

单位：上海交通大学医学院附属新华医院老年医学科, 上海 200092

分类号：R541.3

出版年·卷·期（页码）：2017·36·第六期（781-784）

摘要：

目的：探讨老年男性高血压患者中，左室肥厚与同型半胱氨酸、血糖等代谢指标之间的关系。方法：收集119例患者，进行生化代谢指标、心脏彩色多普勒超声及24 h动态血压等检查，根据左室质量指数将患者分为左室肥厚组（n=46）和非左室肥厚组（n=73），分析两组的检查结果。结果：左室肥厚组的24 h平均收缩压、糖化血红蛋白、同型半胱氨酸均显著高于左室正常构型组（P<0.05），经多元线性逐步回归分析，24 h平均收缩压及同型半胱氨酸与左室质量指数相关。结论：老年高血压患者左室肥厚与多种因素有关，其中，高同型半胱氨酸对左室肥厚的影响独立于其他危险因素。

Objective: To explore the relationship between metabolic markers such as homocysteine, glucose and left ventricular hypertrophy (LVH) in elderly hypertensive males. Methods: 119 patients undertook blood tests, echocardiography and 24 hour ambulatory blood pressure monitoring, then were divided into left ventricular hypertrophy group (LVH) (n=46) and without left ventricular hypertrophy group (NLVH) (n=73). The general data, biochemical paremeters were analyzed. Results: In the LVH group, 24 hour average systolic blood pressure (24 h SBP), glycosylated hemoglobin and homocysteine were higher (P<0.05). Multiple linear stepwise regression analysis showed LVMI significantly correlated with 24 h SBP and homocysteine. Conculsion: LVH was associated with many factors in elderly patients. Hyperhomocysteine was an independent risk factor for LVH.

参考文献：

[1] 卢永昕.高血压:从左室肥厚到心力衰竭[J].中华高血压杂志,2007,15(3):189-191.
[2] JISSHO S,SHIMADA K,TAGUCHI H,et al.Impact of electrocardiographic left ventricular hypertrophy on the occurrence of cardiovascular events in elderly hypertensive patients-the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients(JATOS)[J].Circ J,2010,75(5):938-945.
[3] SUNDSTROM J,LIND L,ARNLOV J,et al.Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men[J].Circulation,2001,103(19):2346-2351.
[4] FOX ER,ALNABHAN N,PENMAN AD,et al.Echocardiographic left ventricular mass index predicts incident stroke in African Americans:atherosclerosis risk in communities (ARIC) study[J].Stroke,2007,38(10):2686-2691.
[5] 李岩,赵冬,刘静等.北京地区25~64岁人群高血压左心室肥厚与心血管事件和死亡的关系[J].中华心血管病杂志,2008,36(11):1037-1042.
[6] HAMMOND ZW,DEVEREUX RB,ALDERMAN MH,et al.Relation of blood pressure and body build to left ventricular mass in normotensive and hypertensive employed adult[J].J Am Coll Cardiol,1988,12(4):996-1004.
[7] DEVEREUX RB,ALONSO DR,LUTAS EM,et al.Echocardiographic assessment of left ventricular hypertrophy:comparison to necropsy findings[J].Am J Cardiol,1986,57(6):450-458.
[8] MANCIA G,DEBACKER G,DOMINICZAK A,et al.2007 Guidelines for the management of arterial hypertension[J].Eur Heart J,2007,28(12):1462-1536.
[9] 陆璐,李燕,黄绮芳,等.单纯夜间高血压与左室肥厚的关系[J],中华内科杂志,2008,47(10):819-822.
[10] 金智敏,赵晓薇,杨宏仁,等.有效控制血压对高危高血压患者左室肥厚的长期影响[J].高血压杂志,2005,13(6):341-343.
[11] 宝辉,苗懿德,刘颖,等.高龄老年高血压患者左室肥厚的相关因素研究[J].中国全科医学,2012,15(2):154-157.
[12] 甄攀攀,蒋东桥,王雯,等.高同型半胱氨酸血症与血管内皮细胞凋亡[J].中华老年心脑血管病杂志,2010,12(7):655-665.
[13] 张志敏,赵连友,卢凡,等.高同型半胱氨酸对高血压大鼠心肌细胞GRP78和CHOP表达及左室肥厚的影响[J].中国循证心血管医学杂志,2014,6(2):223-226.
[14] MAYA P,MONA B,MATAS Z,et al.Determinants of left ventricular hypertrophy in hypertensive patients:identification of high-risk patients by metabolic,vascular,and inflammatory risk factors[J].Int Angiol,2013,22(4):223-228.
[15] ENDO N,NISHIYAMA K,OKABE M,et al.Vitamin B6 suppresses apoptosis of NM-1 bovine endothelial cells induced by homocysteine and copper[J].Biochim Biophys Acta,2007,1770(4):571-577.
[16] 王会芹,郭宏,赵慧.叶酸、维生素B6和维生素B12对高同型半胱氨酸血症大鼠心室重构的影响[J].中国全科医学,2013,(3):275-279.
[17] ABULARRAGE CJ,SIDAWY AN,WHITE PW,et al.Effect of folic acid and vitamins B6 and B12 on microcirculatory vasoreactivity in patients with hyperhomocysteinemia[J].Vasc Endovascular Surg,2007,41(4):339-345.
[18] LONN E,YUSUF S,AMOLD MJ,et al.Homocysteine lowering with folic acid and B vitamins in vascular disease[J].N Engl J Med,2006,354(15):1578-1588.
[19] ERIC Y,DANIEL Y,COLMAN S,et al.Incidence and predictors for cardiovascular disease in chinese patients with type 2 diabetes mellitus-a population-based retrospective cohort study[J].Diabetes Complicat,2016,30(3):444-450.
[20] AN Y,ZHANG P,WANG J,et al.Cardiovascular and all-cause mortality over a 23-year period among chinese with newly diagnosed diabetes in the Da-qing IGT and diabetes study[J].Diabetes Care,2015,38(7):1365-1371.

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