原发性高血压患者血清铁蛋白和同型半胱氨酸水平与颈动脉粥样硬化的相关性研究

doi:10.3969/j.issn.1673-8640.2015.03.005

摘要/Abstract

摘要： 目的

探讨原发性高血压(EH)患者血清铁蛋白(SF)和同型半胱氨酸(Hcy)水平与颈动脉粥样硬化(CAS)的相关性。

方法

采用电化学发光免疫法和循环酶法分别检测266例EH患者的血清SF和Hcy水平。根据颈动脉内膜中层厚度(CIMT,彩色多普勒超声仪)将266例EH患者分为CIMT增厚组(167例,CIMT>1.0 mm)和CIMT非增厚组(99例,CIMT≤1.0 mm),以健康体检者50名作为正常对照组。

结果

CIMT增厚组血清SF和Hcy水平明显高于CIMT非增厚组(t值分别为12.561、4.581,P均<0.01);CIMT非增厚组血清SF和Hcy水平明显高于正常对照组(t值分别为6.305、2.913,P均<0.01)。CIMT增厚组CIMT与血清SF、Hcy水平呈正相关(r值分别为0.597、0.451,P均<0.01)。

结论

EH患者体内存在着高水平的SF和Hcy,与EH合并CAS有相关性。联合检测血清SF和Hcy水平有助于对其病情和预后的判断。

关键词: 铁蛋白, 同型半胱氨酸, 颈动脉内膜中层厚度, 颈动脉粥样硬化, 原发性高血压

Abstract: Objective

To investigate the correlations of serum ferritin (SF) and homocysteine (Hcy) levels with carotid atherosclerosis (CAS)in patients with essential hypertension (EH).

Methods

SF and Hcy levels in 266 patients with EH were determined by electrochemiluminescence immunoassay and circulating enzymatic method. According to carotid intima-media thickness (CIMT, color doppler ultrasound instrument), 266 patients with EH were classified into CIMT thickening group (167 cases, CIMT>1.0 mm) and CIMT non-thickening group (99 cases, CIMT≤1.0 mm). A total of 50 healthy subjects were enrolled as control group.

Results

SF and Hcy levels in CIMT thickening group were significantly higher than those in CIMT non-thickening group(t=12.561 and 4.581, P<0.01). SF and Hcy levels in CIMT non-thickening group were higher than those in control group (t=6.305 and 2.913, P<0.01). SF and Hcy levels in CIMT thickening group were positively correlated with CIMT (r=0.597 and 0.451, P<0.01).

Conclusions

EH patients have high levels of SF and Hcy, and SF and Hcy levels are correlated to EH combined with CAS. The combined detection of SF and Hcy levels contributes to the condition and prognosis judgement.

Key words: Ferritin, Homocysteine, Carotid intima-media thickness, Carotid atherosclerosis, Essential hypertension

中图分类号:

R446.1

杨文东. 原发性高血压患者血清铁蛋白和同型半胱氨酸水平与颈动脉粥样硬化的相关性研究[J]. 检验医学, 2015, 30(3): 227-229.

YANG Wendong. Correlation research on serum ferritin and homocysteine levels with carotid atherosclerosis in essential hypertension patients[J]. Laboratory Medicine, 2015, 30(3): 227-229.

图/表 1

参考文献 15

[1]	蒋永林,蒋荷萍.原发性高血压患者血清Salusin-α、UⅡ与颈动脉IMT的相关性分析[J].检验医学,2012,27(4):284-286.
[2]	刘翠平,黎明,李彬,等.2型糖尿病患者血清瘦素/脂联素比值与颈动脉内膜中层厚度的关系[J].中国实用内科杂志,2007,27(15):1210-1212.
[3]	HÄMÄLÄINEN P, SALTEVO J, KAUTIAINEN H,et al. Erythropoietin, ferrtin,haptoglobin,hemoglobin and transferrin receptor in metabolic syndrome: a case control study[J]. Cardiovasc Diabetol, 2012,11:116.
[4]	杜玉秀,李允亮,杨文东.原发性高血压患者胰岛素抵抗和血管内皮功能的临床观察[J].吉林医学,2008,29(21):1843-1845.
[5]	须静,胡晓波.2型糖尿病患者铁蛋白浓度与胰岛素抵抗的相关性研究[J].检验医学,2013,28(9):805-808.
[6]	吕晓莉, 程功, 李尚俭, 等. 血清脂蛋白a、同型半胱氨酸与急性心肌梗死的相关性分析[J].现代检验医学杂志,2013,28(5):65-67.
[7]	蒋宜, 唐渝平, 史若飞. 血浆脑钠素和同型半胱氨酸在急性冠状动脉综合征中的临床应用价值[J]. 重庆医学, 2013,42(9):1021-1022.
[8]	中国高血压防治指南修订委员会.中国高血压防治指南(2005年修订版)[J].高血压杂志,2005,13(增刊):2-41.
[9]	闫明昌,赵春芝.阿托伐他汀和贝那普利对高血压患者颈动脉内膜中层厚度和血脂水平及超敏C反应蛋白的影响[J].实用心脑肺血管病杂志,2013,21(6):43-45.
[10]	赵景波,王建炳,李健杰,等.血清铁蛋白与原发性高血压关系病例对照研究[J].中国公共卫生,2008,24(2):198-200.
[11]	卢惠茹,WANG Jian, 刘玉芳. 血浆同型半胱氨酸和血清铁蛋白与老年冠心病病变的关系[J].中国老年保健医学,2008,6(4):12-13.
[12]	SUN Y, CHIEN KL, HSU HC, et al.Use of serum homocysteine to predict stroke, coronary heart disease and death in ethnic Chinese.12-year prospective cohort study[J]. Circ J, 2009,73(8):1423-1430.
[13]	何海英. 幽门螺杆菌感染对冠心病患者冠状动脉狭窄与血清同型半胱氨酸的影响[J]. 中华医院感染学杂志, 2012,22(6):1210-1212.
[14]	饶一武, 周晓莉, 李亚新, 等. 血浆同型半胱氨酸水平与高血压微血管并发症的关系[J]. 中国老年学杂志, 2009,29(24):3188-3190.
[15]	张妍, 杜新芳, 刘保军, 等. 急性脑梗死患者血清铁蛋白及血浆同型半胱氨酸测定的临床研究[J]. 中国医师进修杂志, 2010,33(25):38-39.

组别	例数	SF(ng/mL)	Hcy(mmol/L)
CIMT增厚组	167	329.5±88.3^*#	26.2±7.4^*#
CIMT非增厚组	99	197.8±42.6^*	18.9±5.1^*
正常对照组	50	117.5±22.9	12.7±3.8

组别	例数	SF(ng/mL)	Hcy(mmol/L)
CIMT增厚组	167	329.5±88.3^*#	26.2±7.4^*#
CIMT非增厚组	99	197.8±42.6^*	18.9±5.1^*
正常对照组	50	117.5±22.9	12.7±3.8