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目的观察高血压患者血浆同型半胱氨酸(Hcy)水平的变化及其与认知功能的关系。方法入选2012年6月至2015年6月初诊未经治疗的轻中度原发性高血压患者292例,根据所入选高血压患者血浆Hcy的水平分为2组:Hcy<10μmol/L组(Hcy正常组,102例)和Hcy≥10μmol/L组(Hcy升高组,190例);选择同期于医院体检的正常血压人群为对照组(100例)。收集各受试者基线临床资料,分别检测各受试者的血生化指标和Hcy水平,采用简易精神状态量表(MMSE)检查各组受试者的认知功能,比较各组间上述观察指标的差异,并分析Hcy水平与认知功能的关系。结果 Hcy升高组的高血压患者血浆Hcy水平高于Hcy正常组和对照组[Hcy升高组(16.4±2.6)比Hcy正常组(7.3±1.6),对照组(5.8±1.9)μmol/L,均P<0.05];同时,MMSE评分低于Hcy正常组和对照组(Hcy升高组24.4±2.6比Hcy正常组28.6±3.1,对照组30.9±4.3,均P<0.05);Hcy正常组与对照组受试者的血浆Hcy水平及MMSE评分的差异无统计学意义(均P>0.05)。相关分析显示,高血压患者血浆Hcy水平与MMSE呈负相关(r=-0.406,P<0.05)。进一步行非条件Logistic回归分析显示,Hcy是高血压患者认知功能障碍的影响因素(OR3.56,95%CI1.60~7.89,P<0.01)。结论高血压患者认知功能障碍可能与血浆Hcy水平的升高相关。
Objective To observe the changes of plasma homocysteine (Hcy) level and its relationship with cognitive function in patients with hypertension. Methods 292 patients with untreated mild-moderate essential hypertension were enrolled in this study from June 2012 to June 2015. They were divided into 2 groups according to the level of Hcy in plasma: Hcy <10μmol / L group Hcy normal group, 102 cases) and Hcy≥10μmol / L group (Hcy elevated group, 190 cases). The normotensive subjects in the same period of hospital examination were selected as the control group (100 cases). Baseline clinical data of each subject were collected, blood biochemical indexes and Hcy levels of each subjects were measured, MMSE was used to examine the cognitive function of each group, and the above mentioned indicators The differences between Hcy and cognitive function were analyzed. Results The level of Hcy in hypertensive patients with elevated Hcy level was higher than that in normal Hcy group and control group [(16.4 ± 2.6) vs 7.3 ± 1.6 in Hcy normal control group (5.8 ± 1.9) μmol / L , All P <0.05]. Meanwhile, MMSE score was lower than that of Hcy normal group and control group (24.4 ± 2.6 in Hcy elevation group, 28.6 ± 3.1 in Hcy normal group, 30.9 ± 4.3 in control group, P <0.05) There were no significant differences in plasma Hcy levels and MMSE scores between the two groups (all P> 0.05). Correlation analysis showed that plasma Hcy levels in patients with hypertension were negatively correlated with MMSE (r = -0.406, P <0.05). Further line non-conditional logistic regression analysis showed that Hcy was the influencing factor of cognitive dysfunction in hypertensive patients (OR 3.56, 95% CI 1.60 ~ 7.89, P <0.01). Conclusion Cognitive dysfunction in hypertensive patients may be related to the increase of plasma Hcy level.