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Objective:To summarize characteristics and rules of blood pressure variability (BPV) in children with H-type hypertension, in an attempt to explore some basis for further selection of the time points of treatment.Methods:A total of 117 children diagnosed as essential hypertension in Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2018 to September 2019 were selected as the research objective.According to the serum level of homocysteine (Hcy), those children were divided into the simple essential hypertension group (74 cases, Hcy≤13.9 μmol/L) and the H-type hypertension group (43 cases, Hcy>13.9 μmol/L). All children received 24 h ambulatory blood pressure monitoring (24 h ABPM), and BPV indexes were recorded and subject to group comparison.Meanwhile, the serum Hcy level was monitored.Besides, the demographic data and such blood biochemical indexes as blood glucose, blood fat and renal function were recorded or measured for an analysis of the correlation between BPV and each index.Results:There were no significant differences in gender, age, body mass index (BMI) and biochemical indexes between the simple essential hypertension group and the H-type hypertension group (all P>0.05). Compared with the simple essential hypertension group, the H-type hypertension group had a significantly higher 24 h systolic blood pressure standard deviation [24 h SSD, (11.21±3.23) mmHg vs.(9.64±2.73) mmHg, 1 mmHg=0.133 kPa, t=-2.806, P<0.05], nighttime systolic blood pressure standard deviation [nSSD, (10.79±3.89) mmHg vs.(9.26±3.23) mmHg, t=-2.292, P<0.05], and nighttime diastolic blood pressure standard deviation [nDSD, (10.23±3.53) mmHg vs.(8.73±2.93) mmHg, t=-2.617, P<0.05]. Pearson correlation analysis showed that the serum Hcy level was significantly positively correlated with 24 h, SSD, nSSD and nDSD ( r=0.194, 0.183, 0.182, all P<0.05). Conclusions:24 h SSD in children with H-type hypertension is significantly higher, with an obvious increase in both nSSD and nDSD, and the serum Hcy level was significantly positively correlated with BPV, which suggested that it was required to effectively control the serum Hcy level, reduce the range of blood pressure fluctuation and select the optimal time points of treatment, thus delaying the progress of hypertension.
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A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ⩾ 15.0µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY 15.0µmol/L). Finally, 110 551 residents ⩾ 40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9µmol/L (interquartile range 7.9-15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338-2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.
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Humans , Male , China/epidemiology , Hyperhomocysteinemia/epidemiology , Hypertension/epidemiology , Prevalence , Risk Factors , Stroke/epidemiologyABSTRACT
OBJECTIVES: To explore the risk factors of essential hypertension with hyperhomocysteinemia (H-type hypertension) and design a nomogram to predict this risk. METHODS: A hospital-based study was conducted on 1,712 individuals, including 282 patients with H-type hypertension, 105 patients with simple hypertension, 645 individuals with hyperhomocysteinemia, and 680 healthy controls. Logistic regression and nomogram models were applied to evaluate the risk factors. RESULTS: Logistic regression showed that advanced age, male sex, high body mass index (BMI), high total cholesterol levels, high glucose levels, and high creatinine levels were risk factors of H-type hypertension in the healthy population and were integrated into the nomogram model. Advanced age, male sex, high BMI, high total cholesterol levels, and high glucose levels were shown to be risk factors of H-type hypertension in the hyperhomocysteinemia population. Male sex and high creatinine levels were shown to be risk factors of H-type hypertension in the hypertension population. Nomogram analysis showed that the total factor score ranged from 106 to 206, and the corresponding risk rate ranged from 0.05 to 0.95. CONCLUSIONS: Men are more likely to have H-type hypertension, and advanced age, high BMI, high total cholesterol levels, and high glucose levels are risk factors of H-type hypertension in healthy and hyperhomocysteinemia populations. Furthermore, high creatinine level is a risk factor of H-type hypertension in healthy and hypertension populations. Nomogram models may be used to intuitively evaluate H-type hypertension risk and provide a basis for personalized interventions.
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Humans , Male , Hyperhomocysteinemia/complications , Hyperhomocysteinemia/epidemiology , Hypertension/complications , Hypertension/epidemiology , Risk Factors , Nomograms , Essential Hypertension , HospitalsABSTRACT
Objective::To discuss the clinical efficacy of Liuwei Dihuangwan combined with Danzi Xiaoyaosan on H-type hypertension with syndrome of Yin deficiency and Yang hyperactivity and its effect on vascular endothelial function and inflammatory factors. Method::One hundred and fifty patients were randomly divided into control group (75 cases) and observation group (75 cases) by random number table.Patients in control group got enalapril maleate and folic acid tablets, 1 tablet/time, 1 time/day, and patients with uncontrollable blood pressure were also given nifedipine sustained-release tablets, 20-30 mg/time, 2 times/days.In addition of the therapy of control group, patients in observation group were also given modified Liuwei Dihuangwan combined with Danzi Xiaoyaosan, 1 dose/day.The course of treatment was 12 weeks.Before and after treatment, systolic blood pressure (SBP), diastolic blood pressure (DBP) and up-to-standard blood pressure were detected.And ambulatory blood pressure, standard deviation of 24-hours systolic blood pressure (24 h SSD), standard deviation of 24-hour diastolic blood pressure 24 h DSD), 24 h mean systolic blood pressure (24 h SBP), 24 h mean diastolic blood pressure (24 h DBP) were recorded.And ankle brachial index (ABI) and brachial artery blood flow mediated diamete (FMD) were discussed, syndrome of Yin deficiency and Yang hyperactivity was scored, and levels of iterleukin-6 (IL-6), IL-10, high-sensitivity C-reactive protein (hsCRP) and homocysteine (Hcy) were detected. Result::The levels of SBP, DBP, 24 h SSD, 24 h DSD, 24 h SBP and 24 h DBP were all lower than those in control group (P<0.01). The achievement rate of accidental blood pressure in observation group was 81.19%, which was higher than 66.98% in control group (χ2=29.81, P<0.01). And levels of ABI, FMD and IL-10 were higher than those in control group (P<0.01), while the score of syndrome of Yin Deficiency and Yang Hyperactivity and the levels of Hcy, leptin, IL-6 and hs-CRP were lower than those in control group (P<0.01). Conclusion::In addition to the therapy of antihypertensive and folic acid, Liuwei Dihuangwan combined with Danzi Xiaoyaosan can be given to control the level of blood pressure and Hcy, relieve the variability of blood pressure, alleviate clinical symptoms, raise the rate of achievement rate of blood pressure, improve the function of vascular endothelium, and regulate inflammatory factors.
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Objective@#To analyze the effects of green aerobics on serum homocysteine concentration and the morning surge in blood pressure in H-type hypertension patients with ischemic stroke.@*Methods@#The 125 patients who suffer from H-type hypertension as well as ischemic stroke were divided into two groups by random digital table method. The control group (60 cases) accepted neurology normal nursing, while the intervention group (65 cases) accepted green aerobics intervention except the neurology normal nursing. The patients′ homocysteine level and the morning surge in blood pressure were assessed in two groups.@*Results@#Two weeks later, the homocysteine level in the control group was (9.44±2.07) mmol/L, while the intervention group was (11.62±3.03) mmol/L. The difference between the two groups had statistics significance(t=-5.257, P <0.05). The morning surge in blood pressure was (18.75±7.51) mmHg(1 mmHg=0.133 kPa), while the control group was (34.07±2.91) mmHg. The difference between the two groups had statistics significance (t=15.761, P <0.05).@*Conclusions@#The green aerobics could effectively lower the homocysteine level and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke. It was an alternative therapy or assistant therapy without side effects.
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Objective To analyze the effects of green aerobics on serum homocysteine concentration and the morning surge in blood pressure in H-type hypertension patients with ischemic stroke. Methods The 125 patients who suffer from H-type hypertension as well as ischemic stroke were divided into two groups by random digital table method. The control group (60 cases) accepted neurology normal nursing, while the intervention group (65 cases) accepted green aerobics intervention except the neurology normal nursing. The patients′homocysteine level and the morning surge in blood pressure were assessed in two groups. Results Two weeks later, the homocysteine level in the control group was (9.44± 2.07) mmol/L, while the intervention group was (11.62 ± 3.03) mmol/L. The difference between the two groups had statistics significance(t=-5.257, P<0.05). The morning surge in blood pressure was (18.75± 7.51) mmHg(1 mmHg=0.133 kPa), while the control group was (34.07 ± 2.91) mmHg. The difference between the two groups had statistics significance (t =15.761, P <0.05). Conclusions The green aerobics could effectively lower the homocysteine level and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke. It was an alternative therapy or assistant therapy without side effects.
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Objective To investigate the changes of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and omentin-1 in patients with H-type hypertension complicated with acute ischemic stroke, and to analyze the correlation of sLOX-1 and omentin-1 levels with the severity and prognosis of the disease.Methods Totally 136 patients with H-type hypertension complicated with acute ischemic stroke from February2017 to May 2018 were selected as observation group, and 136 non-acute ischemic stroke patients with H-type hypertension in the same period as the control group. The patients of observation group were divided into mild, moderate and severe sub-groups according to NIHSS score, and they were also divided into good prognosis group and poor prognosis group based on modified RANKIN scale (mRS) score. The serum sLOX-1 and omentin-1 levels were detected, and the correlation of sLOX-1 and omentin-1 levels with severity and prognosis of disease was analyzed. Results The serum sLOX-1 level of the observation group was higher, but the serum omentin-1 level lower than that of control group (P < 0.05). With the severity of the disease, the serum sLOX-1 level increased, but the serum omentin-1 level decreased (P < 0.05). The serum sLOX-1 level of good prognosis group was significantly lower, whereas the serum omentin-1 level significantly higher than that of poor prognosis group (P < 0.05). sLOX-1 was positively correlated with NIHSS score and mRS score, while omentin-1 was negatively correlated with NIHSS score and mRS score (P < 0.05). Conclusions The levels of serum sLOX-1 and omentin-1 are closely related to the severity and prognosis of patients with H-type hypertension complicated with acute ischemic stroke, which could be used as markers for evaluating the severity and prognosis of the patients.
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Objective:To investigate the blood pressure variability and its clinical significance in patients with acute cerebral infarction who combined with H type hypertension.Methods: 95 patients with acute cerebral infarction who combined with H type hypertension were enrolled in the perspective study. According to the homocysteine(Hcy) level of patients, they were divided into observation group ( Hcy ≥10mmol/L, 51cases) and control group (Hcy<10mmol/L, 44cases). The blood pressure variability and main clinical features of these patients in the two groups in 24h were observed. At the same time, the correlation between blood pressure variability and main clinical feature in observation group were analyzed.Results: The 24h systolic pressure variability, 24h diastolic pressure variability, carotid intima-media thickness and national institute of health stroke scale (NIHSS) of observation group were 14.57±4.62, 18.57±5.38, 13.39±4.85 mm and 1.27±0.17, respectively. While they were 12.48±3.78, 16.12±5.74, 11.34±4.32 mm and 1.09±0.13 in the control group, respectively. And the differences of them between the two groups were statistical significance (t=2.389,t=2.146,t=2.160,t=5.725,P<0.05). Besides, there was obvious positive correlation between 24h systolic pressure variability and NIHSS of patients with acute cerebral infarction (r=0.254,P<0.05), and there was also obvious positive correlation between 24h systolic pressure variability and thickness of carotid intima-media (r=0.256,P<0.05).Conclusion: Increased blood pressure variability in patients with acute hypertensive cerebral infarction combined with H type hypertension may be related to poor prognosis of patients and vascular intima thickness.
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Objective To investigate the target organs function damage in elderly patients with H type hypertension and its association with blood pressure variability.Methods Ninety-two patients with H type hypertension in the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to January 2016 were collected as the observation group and contemporaneous 135 elderly patients with non-H type hypertension were collected as the control group.The main observation indicators included 24 h systolic/diastolic blood pressure variability,24 h average systolic/diastolic blood pressure,glomerular filtration rate(GFR),serum creatinine,24 h urinary microalbumin,carotid intima-media thickness and left ventricular mass index.Results Compared with the control group,24 h systolic blood pressure variability,24 h diastolic blood pressure variability,creatinine,24 h urinary microalbumin,carotid intima-media thickness and left ventricular mass index in the observation group were significantly increased(P＜0.05);GFR was significantly decreased (P＜0.05).The multiple linear regression analysis showed that 24 h systolic blood pressure variability was the factors affecting GFR (P＜0.05);24 h systolic blood pressure variability was the factor affecting~the creatinine level (P＜0.05);24 h systolic blood pressure,24 h systolic blood pressure variability and 24 h diastolic blood pressure variability were the influence factors of carotid intima-media thickness (P＜0.05);24 h systolic blood pressure variability was the influence factor of left ventricular mass index (P＜0.05).Conclusion The target organs function damage in the patients with H type hypertension is serious,and the blood pressurevariability enlargement is the influencing factor of target organs function damage.
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Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.
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OBJECTIVE: To investigate the effects of Enalapril maleate folic acid tablets on carotid atherosclerosis in H type hypertension patients with type 2 diabetes mellitus (T2DM) and its potential mechanism.METHODS: In prospective control study, 182 H type hypertension patients with T2DM were selected from Chongqing People's Hospital during Jan. 2014-Jan. 2016, and then randomly divided into observation group and control group, with 91 cases in each group. All patients received basic or hypoglycemic treatment of premixed insulin; observation group was additionally given Enalapril maleate folic acid tablets (containing enalapril maleate 10 mg, folic acid 0. 8 mg in each tablet) orally, one tablet, qd; control group was additionally given Enalapril maleate tablets (containing enalapril maleate 10 mg in each tablet) orally, one tablet, qd. Treatment course lasted for 12 months. The levels of blood pressure, plasma homocysteine (Hcy), fasting blood glucose (FBG), C-reactive protein (CRP) and carotid plaque score were detected in 2 groups before treatment, 12 months after treatment. RESULTS: Compared to before treatment, SBP and DBP of 2 groups were decreased significantly in 2 groups after 12 months of treatment (P<0. 05); there was no statistical significance between 2 groups (P>0. 05). The levels of plasma Hcy, FBG and CRP, carotid intima-media thickness and carotid plaque integral in observation group were significantly lower than control group (P<0. 05). CONCLUSIONS: Enalapril maleate folic acid tablets can relieve inflammation by reducing plasma Hcy, FBG and CRP so as to treat carotid atherosclerosis in H type hypertension patients with T2DM.
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Objective To investigate the effect of losartan combined folic acid on heart rate variability in H-type hypertension patients complicated with acute cerebral infarction.Methods Fifty six cases of H-type hypertension complicated with acute cerebral infarction patients admitted to our hospital were collected from March 2016 to March 2017,and were randomly divided into the study group and the control group,each with 28 cases.The research team were treated with losartan tablet 50mg/d and folic acid tablet 0.8mg/d;and the control group were treated with osartan tablet 50mg/d alone.The changes of heart rate variability and serum homocysteine levels were compared between two groups.Results When compared with the control group,the systolic blood pressure reduced more (t =2.878,P =0.006) in the study group,but there was no statistical significance in diastolic blood pressure (P ＞ 0.05).After treatment,the SDNN significantly increased (t =2.267,P =0.027),SDANN significantly increased (t =2.106,P =0.039);RMSSD significantly increased (t =2.192,P =0.032),PNN50 significantly increased (t =2.889,P =0.006).LF significantly increased (t =2.024,P =0.048),HF significantly increased (t =2.365,P =0.022),LF/HF significantly decreased (t =2.195,P =0.033) in the study group.The serum homocysteine level of study group was significantly decreased (t =4.958,P =0.000) after treatment,and significantly lower than the control group (t =4.710,P =0.000).Conclusion The combination of losartan and folic acid can effectively improve the heart rate variability in H-type hypertension patients complicated with acute cerebral infarction.
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Objective To analyze changes of serum uric acid (SUA) and carotid lesions in H type hypertension patients with type 2 diabetes mellitus (T2DM) and explore the risk factors of H type hypertension with T2DM. Methods A total of 119 patients diagnosed as H-type hypertension and admitted to our hospital from November 2016 to December 2017 were included in this study. Patients were divided into two groups according to whether they were combined with T2DM: 64 cases in simple H type hypertension group (simple group) and 55 cases in H type hypertension combined with T2DM group (combined group). Fifty healthy people in healthy physical examination at the same period were enrolled in this study as the control group. Questionnaires (age, gender, hypertensive history, cerebrovascular history, smoking history and drinking history) were collected in patients. The blood biochemical indicators including homocysteine (Hcy), SUA, fasting plasma glucose (FPG), triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected. The color Doppler ultrasonography was used to measure carotid intima-media thickness (cIMT). The carotid plaque scores were also measured. The risk factors of H type hypertension with T2DM were analyzed by multivariate Logistic regression. Results Values of SUA, cIMT incrassation ratio, carotid plaque score, carotid plaque detection rate, cerebrovascular history, smoking history and drinking history in simple group was higher than control group and lower than combined group (P＜0.05). Data of hypertension and Hcy were increased in simple group and combined group (P＜0.05). The serum level of FPG was significantly higher in combined group than that of control group and simple group (P＜0.05). There were no significant differences in hypertensive history, blood pressure and Hcy between simple group and combined group. There were no significant differences in TC, TG, HDL-C and LDL-C between three groups. Multivariate Logistic regression analysis showed that the elevated SUA ( OR=1.015, 95% CI : 1.008-1.023), cIMT incrassation ( OR=13.754, 95% CI : 2.556-74.016) and smoking history ( OR=5.229, 95% CI : 2.872-9.775) were risk factors for H type hypertension with T2DM. Conclusion For patients with hypertension and T2DM, Hcy, SUA and cIMT should be routinely tested, which can take corresponding intervention at early stage to prevent atherosclerosis and control the occurrence of cardiovascular and cerebrovascular diseases effectively.
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Objective: To explore the clinical significance of transcranial Doppler flow grades for patients with acute cerebral infarction combined with H type hypertension. Methods: 92 patients with acute cerebral infarction combined with H type hypertension were divided into observation group, and 78 patients with acute cerebral infarction were divided into control group during the same period. The differences of the two groups were compared and researched. The correlation between transcranial Doppler flow grade of acute cerebral infarction combined with H type hypertension and the score of NIHSS was compared and analyzed. Results: As the results of transcranial Doppler flow grades, the ratio of the patients in 0 grade was 10.87% in observation group, and it was significantly higher than that of control group (1.28%) (x2=4.925, P<0.05). The ratio of the patients in 5 grade was 6.52% in observation group, and it was significantly lower than that of control group (21.79%) (x2=8.417, P<0.05). The blood flow velocities of systole and diastole of observation group were significantly lower than that of control group (t=3.645, t=5.251, P<0.05), respectively. The cerebral infarct size of observation group was significantly larger than that of control (t=4.405, P<0.05). The score of NIHSS of observation group was significantly higher than that of control group (t=2.688, P<0.05). The results of Pearson linear correlation analysis indicated that there was a significantly negative correlation between transcranial Doppler flow grades and NIHSS (r=-0.284, P<0.05). Conclusion: The transcranial Doppler flow grades can identify the order of severity for patients with acute cerebral infarction combined with H type hypertension.
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Objective By analyzing the mortality of patients with hypertension and cerebral infarction in different blood lipid stratification,the significance of blood lipid stratification management in the treatment of hypertension was clarified.Methods 604 patients with hypertension combined with cerebral infarction were divided into middle risk group (198 cases),high risk group (n=198) and extremely high risk group (n=208) and each group of different stratification according to the serum lipid HCY level,divided into H type hypertension group (HCY=10 μmol/L) and hypertension group ((HCY＜10 μmol/L group) and comparison of the 10 year mortality in each group.Results Comparison of mortality between H type hypertension group and simple hypertension group,among them,the difference between the two groups in middle risk group was statistically significant (x2 =5.095,P =0.024 205).The difference between the two groups in extremely high risk group was statistically significant (x2 =7.859,P=0.005 056).The difference between the two groups in high risk group was statistically significant (x2 =9.961,P=0.001 599).There was a significant difference in mortality between the groups with different blood lipids in simple hypertension group.Among the high-risk group and the middle risk group,the difference was statistically significant (x2=6.575,P=0.010 343),and there was significant difference between high risk group and high risk group (x2 =6.868,P=0.008 774).Comparison of mortality between different lipid levels in H type hypertension group,the difference was statistically significant.There was significant difference between the extremely high risk group and the high risk group (x2 =4.745,P=0.029 388) and there was significant difference between the high risk group and the middle risk group (x2 =11.668,P=0.000 636).Conclusion Hyperlipidemia,especially high LDL and high HCY are the main causes of death in patients with hypertension complicated with cerebral infarction,the clinical use of blood lipid levels can reduce the level of LDL and reduce the mortality of patients by strengthening the control of HCY level.Improve the survival rate of patients.
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Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.
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Objective To study the expression and significance of urinary albumin/creatinine (UAlb/Cr) ,glomerular filtration rate (eGFR) ,serum creatinine (SCr) and cystatin C (Cys-C) in H-type hypertension patients with early renal damage .Methods Totally 130 cases of H-type hypertensive patients from July 2015 to June 2016 in this hospital was conducted .According to glomer-ular filtration rate (GFR) ,those patients were divided into normal renal function group (n=62 ,GFR≥90 mL/L) and kidney dam-age group (n=73 ,GFR<90 mL/L) .Cys-C was detected by latex turbidimetry and UAlb/Cr ,SCr was detected by creatine oxidase method ,MDRD were used to calculate eGFR .The expression of UAlb/Cr ,eGFR ,SCr and Cys-C were analyzed ,and the risk factors of UAlb/Cr and eGFR were analyzed by Logistic regression analysis .Results The levels of UAlb/Cr ,SCr and Cys-C in normal re-nal function group were lower than those in kidney damage group (P<0 .05) ,and the level of eGFR was significantly higher than that of kidney damage group (P<0 .05) .Age ,course of disease ,Hcy ,DBP were closely related to UAlb/Cr(P<0 .05) .Age ,course of disease ,Hcy were closely related to eGFR (P<0 .05) .Conclusion The expression of UAlb/Cr ,eGFR ,SCr and Cys-C is closely related to H-type hypertension patients with early kidney damage .
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Objective To study the expression and significance of urinary albumin/creatinine (UAlb/Cr) ,glomerular filtration rate (eGFR) ,serum creatinine (SCr) and cystatin C (Cys-C) in H-type hypertension patients with early renal damage .Methods Totally 130 cases of H-type hypertensive patients from July 2015 to June 2016 in this hospital was conducted .According to glomer-ular filtration rate (GFR) ,those patients were divided into normal renal function group (n=62 ,GFR≥90 mL/L) and kidney dam-age group (n=73 ,GFR<90 mL/L) .Cys-C was detected by latex turbidimetry and UAlb/Cr ,SCr was detected by creatine oxidase method ,MDRD were used to calculate eGFR .The expression of UAlb/Cr ,eGFR ,SCr and Cys-C were analyzed ,and the risk factors of UAlb/Cr and eGFR were analyzed by Logistic regression analysis .Results The levels of UAlb/Cr ,SCr and Cys-C in normal re-nal function group were lower than those in kidney damage group (P<0 .05) ,and the level of eGFR was significantly higher than that of kidney damage group (P<0 .05) .Age ,course of disease ,Hcy ,DBP were closely related to UAlb/Cr(P<0 .05) .Age ,course of disease ,Hcy were closely related to eGFR (P<0 .05) .Conclusion The expression of UAlb/Cr ,eGFR ,SCr and Cys-C is closely related to H-type hypertension patients with early kidney damage .
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Objective To investigate the impacts of mecobalamin on plasma inflammatory factors (plasma high-sensitivity C-reactive protein (Hs-CRP) and carotid artery plaques in patients with H type hypertension.Methods Forty-eight acute ischemic stroke patients who were diagnosed with H type hypertension in the People's Hospital of Taixing were collected,and they were randomly divided them into treatment group and control group,and 24 cases of each group.Patients in both groups were given conventional therapies,including treatment of anti platelet aggregation,plaque stability and reduced plaque treatment.While patients in the treatment group were given additional oral drug of mecobalamin,500 μg each time,three times a day,6 months in all.Each case was evaluated at the second day of hospitalization,four weeks later,eight weeks later,three months and sixth months later.The examination items involved included level of plasma homocysteine(Hcy),level of hsCRP and conditions of carotid artery plaques under ultrasonography.Results Aafter four weeks,eight weeks,three months and sixth months therapy,there were significant differences between treatment group and control group in terms of Hcy (t =4.049,3.896,6.052,6.159 ; P ＜ 0.05) and the level of hs-CRP (t =37.249,28.376,26.454,0.522P ＜ 0.01).Afrter three months and sixth months therapy,compared to the control group,the carotid artery plaques were obviously reduced,and the differences were statistically significant (t =2.309,2.434 ; P ＜ 0.05).Conclusion Mecobalamin can reduce the level of plasma homocysteine,then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques.
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Objective To investigate the relationship of serum levels of homocysteine, cystain C and uric acid with ca?rotid atherosclerosis in H-type hypertension patients. Methods A total of 132 H-type hypertension patients were collected to be studied. Their carotid intima-media thickness (IMT) was measured by Doppler ultrasonography. And according to the result of carotid artery atherosclerosis, all patients were divided into normal cIMT group (n=40),thickened cIMT group (n=43) and plague formation group (n=49). Their serum Hcy, Cyst-C, UA, blood glucose, blood lipid, blood urea nitrogen and se?rum creatinine were compared among three group and their relationship with cIMT were analyzed. Logistic regression was used to screen risk factors for carotid atherosclerosis. Results There was no significant difference in serum levels of blood glucose,blood urea nitrogen, creatinine, serum creatinine (Scr), triglyceride (TG), total cholesterol (TC), low density lipppro?tein cholesterol (LDL-c) among these three groups (P>0.05). The level of high-density lipoprotein (HDL-c) in thickened cIMT group was higher than that in plague formation group, and lower than normal cIMT group, while both serum levels of Cyst-c and UA were lower in thickened cIMT group than those in plague formation group but higher than those in normal cIMT group (P<0.05). In addition, serum level of Hcy in normal cIMT group was higher than that in thickened cIMT group and plague formation group. The cIMT grade was positively correlated with serum levels of Hcy, Cyst-C and UA (r=0.26, 0.30, 0.23, P<0.05), but was negative correlated with HDL-c(r=-0.38, P<0.05). Further more, Logistic regression analy?sis showed that Hcy,Cyst-C and UA were independent risk factors for cIMT. Conclusion Serum levels of Hcy, Cyst-C and UA are closely related to the cIMT,which indicates that they are independent risk factors of cIMT and may be used as mark?ers in judging the developments and preventions of arteriosclerosis.