Structural changes of carotid artery and the relationship with hydrogen sulfide level in patients with H-type hypertension
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摘要: 目的:对H型高血压患者颈动脉结构进行检测, 并研究其与血浆硫化氢的相关性。方法:随机选择2016-01-2017-01在我院门诊及住院的原发性高血压患者。按照血浆同型半胱氨酸水平将符合入选标准的患者分为单纯高血压组 (原发性高血压+血浆同型半胱氨酸＜10μmol/L)、H型高血压组 (原发性高血压+血浆同型半胱氨酸 ≥ 10μmol/L) 及健康人群 (对照组), 并进行实验室相关检查, 包括血浆同型半胱氨酸、硫化氢、高敏C反应蛋白和颈动脉超声检查, 评价患者颈动脉内中膜厚度 (intima media thickness, IMT) 和狭窄程度。结果:H型高血压组与单纯高血压组和对照组比较, 颈动脉IMT显著增厚[(1.49±0.28) mm:(1.30±0.29) mm:(0.89±0.20) mm], Crouse积分更高 (2.00±1.36:1.31±1.08:0.32±0.62), 动脉狭窄程度更严重, 差异有统计学意义 (P＜0.05);H型高血压组的高敏C反应蛋白水平明显高于单纯高血压组及对照组[(994.0±249.6) mg/L:(709.8±217.7) mg/L:(449.2±159.2) mg/L], 差异有统计学意义 (P＜0.05);H型高血压组、单纯高血压组和对照组间的血浆硫化氢水平均差异有统计学意义[(19.74±13.19) pg/ml:(32.92±14.84) pg/ml:(47.00±9.61) pg/ml], H型高血压组明显低于其他两组 (P＜0.05)。结论:H型高血压会加速了动脉粥样硬化的形成和发展。血浆硫化氢水平的下降导致血管的保护性作用减弱也可能是导致H型高血压患者动脉硬化加速的原因之一。Abstract: Objective: To inspect the structure of carotid artery in H-type hypertension patients and study its correlation with hydrogen sulfide level in blood plasma.Method: Randomized selection of primary hypertension patients from January 2016 to January 2017 was performed in our hospital from outpatients and inpatients.According to plasma homocysteine level, patients were divided into isolated systolic hypertension group (primary hypertension, Hcy in blood plasma＜10μmol/L), H-type hypertension group (primary hypertension+ Hcy in blood plasma ≥ 10μmol/L) and healthy group (control group).All groups received relevant laboratory tests, including homocysteine level, hydrogen sulfide and high-sensitivity C-reactive protein.Carotid ultrasonography was employed to assess intima media thickness (IMT) and carotid artery stenosis.Result: Compared with isolated systolic hypertension group and control group, H-type hypertension group showed a significantly increased IMT[(1.49±0.28) mm vs (1.30±0.29) mm vs (0.89±0.20) mm]and higher Crouse points (2.00±1.36 vs 1.31±1.08 vs 0.32±0.62) and more severe carotid artery stenosis (P＜0.05).Hs-CRP level of the H-type hypertension group was significantly higher than that of the isolated systolic hypertension group and the control group[(994.0±249.6) mg/L vs (709.8±217.7) mg/L vs (449.2±159.2) mg/L] (P＜0.05).There were significant statistical differences in the level of hydrogen sulfide among the H-type hypertension group, the isolated systolic hypertension group and the control group, and the level of hydrogen sulfide of H-type hypertension group was significantly lower than that of other two groups[(19.74±13.19) pg/ml vs (32.92±14.84) pg/ml vs (47.00±9.61) pg/ml] (P＜0.05).Conclusion: H-type hypertension can accelerate the formation and development of atherosclerosis.Decrease in the protective function of blood vessel due to a reduced level of hydrogen sulfide in blood plasma may be also a possible cause of acceleration of arteriosclerosis among H-type hypertension patients.
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Key words:
- H-type hypertension /
- carotid atherosclerosis /
- hydrogen sulfide
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