目的：探讨H型高血压患者血清同型半胱氨酸（Hcy）水平与冠状动脉狭窄的关系。方法：选取95例H型高血压合并冠状动脉性心脏病（CHD）患者（血清Hcy ≥ 10 μmol·L^-1）为实验组，同时选取79例原发性高血压合并CHD患者（血清Hcy<10 μmol·L^-1）为对照组，比较两组性别，年龄，吸烟史，收缩压，舒张压，血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、超敏C-反应蛋白、铁蛋白水平和冠状动脉Gensini积分。结果：实验组Hcy水平显著高于对照组[（34.22±18.26）μmol·L^-1 vs（7.02±2.34）μmol·L^-1]。实验组冠状动脉Gensini积分显著高于对照组，两组患者冠状动脉狭窄程度差异有统计学意义（P<0.01）。相关性分析显示，实验组患者血清Hcy水平与Gensini积分呈正相关（r=1，P=0.000）。结论：血清Hcy水平是CHD独立的危险因素，H型高血压患者血清Hcy水平与冠状动脉狭窄程度呈正相关。

[1] ROGER V L,GO A S,LLOYD-JONES D M,et al.Executive summary:heart disease and stroke statistics——2012 update:a report from the American Heart Association[J].Circulation,2012,125(1):188-197.
[2] GUPTA S,GUDAPATI R,GAURAV K,et al.Emerging risk factors for cardiovascular diseases:Indian context[J].Indian J Endocrinol Metab,2013,17(5):806-814.
[3] WU W,GUAN Y,XU K,et al.Plasma homocysteine levels predict the risk of acute cerebral infarction in patients with carotid artery lesions[J].Mol Neurobiol,2016,53(4):2510-2517.
[4] WASKIEWICZ A,PIOTROWSKI W,BRODA G A,et al.Impact of MTHFR C677T gene polymorphism and vitamins intake on homocysteine concentration in the polish adult population[J].Kardiol Pol,2011,69(12):1259-1265.
[5] AROUINO A,RICHARO J.Homocysyeine and cardiovascular risk[J].JACC,2011,58:1034-1035.
[6] 胡大一,徐希平.有效控制"H型"高血压——预防卒中的新思路[J].中华内科杂志,2008,47(12):976-977.
[7] 李建平,霍勇,刘平,等.马来酸依那普利叶酸片降压、降同型半胱氨酸的疗效和安全性[J].北京大学学报(医学版),2007,39(6):614-618.
[8] 李永伟,郭孝兰,刘心伟,等.同型半胱氨酸及视黄醇结合蛋白检测在冠心病诊断中的应用[J].中国老年学杂志,2017,37(10):2415-2416.
[9] VEERANNA V,ZALAWADIYA S K,NIRAJ A,et al.Homocysteine and reclassification of cardiovascular disease risk[J].J Am Coll Cardiol,2011,58(10):1025-1033.
[10] HAUCKE E,NAVARRETE SANTOS A,SIMM A,et al.Accumulation of advanced glycation end products in the rabbit blastocyst under maternal diabetes[J].Reproduction,2014,148(2):169-178.
[11] 杜世春,苏青.晚期糖基化终末产物:糖尿病肾病治疗的新靶点[J].国际内分泌代谢杂志,2012,32(4):239-241.
[12] MONTUSCHI A,IAZZOLINO B,CALVO A,et al.Cognitive correlates in amyotrophic lateral sclerosis:a population-based study in Italy[J].J Neurol Neurosurg Psychiatry,2015,86(2):168-173.
[13] LIU C,CHEN L,YANG Y,et al.Myeloperoxidase and high-sensitivity c-reactive protein for predicting major adverse cardiovascular events in patients with coronary heart disease[J].Int J Clin Med,2015,6(4):262-270.
[14] ROSS R.Atherosclerosis——an inflammatory disease[J].N Engl J Med,1999,340(2):115-126.
[15] LIBBY P.Inflammation and atherosclerosis[J].Circulation,2002,5(9):1135-1143.
[16] SINGH P,SINGH M,NAGPAL H S,et al.A novel haplotype within C-reactive protein gene influences CRP levels and coronary heart disease risk in Northwest Indians[J].Mol Biol Rep,2014,41(9):5851-5862.
[17] OKOCHA C E,ANEKE C J,IBEH N,et al.Evaluation of serum ferritin levels and blood counts in apparently normal individuals in Nnewi,South-east Nigeria[J].Niger J Med,2015,24(1):64-70.