Study on the relationship between H type hypertension as well as the changes of serum lipid and white matter lesions / 中国基层医药

ABSTRACT

Objective To investigate the relationship between H type hypertension as well as the changes of serum lipid and white matter lesions(WML).Methods From January 2015 to October 2017,the clinical characteristics of 507 WML patients who admitted to the Affiliated Hospital of Chengde Medical College were analyzed retrospectively. The patients were divided into simple hypertension group(A group,hypertension accompanied by Hcy ＜10μmol/L, 111cases),simple homocysteine group(B group,patients without high blood pressure with homocysteine ＞10μmol/L, 132cases)and H type hypertension group (C group,hypertension accompanied by homocysteine ＞10μmol/L,264cases)according to homocysteine concentration and hypertension.The patients'clinical data,including imaging information such as MRI,diffusion weighted imaging(DWI),and levels of homocysteine (Hcy),serum lipid were collected.The patients were divided into three subgroups based on the severity of WML,including the mild,moderate,severe.The differences of TG,TC,HDL -C,LDL -C,Apo -A1,Apo -B in each group were compared.Results The levels of TC in A,B and C group were (4.14 ±1.16)mmol/L,(4.39 ±1.39)mmol/L,(3.67 ±1.29)mmol/L,respectively.The levels of LDL -C in the three groups were (2.24 ±0.88)mmol/L,(2.38 ±0.91)mmol/L and (1.99 ±0.89)mmol/L,respectively.Compared with A group and B group,the levels of TC and LDL -C in C group were lower(F =15.411,9.271,all P <0.05).In A group,the number of mild WML,moderate and severe WML accounted for 51.4%,32.4% and 16.2%,which in B group accounted for 50.0%,33.3% and 16.7%,which in C group accounted for 32.6%,33.3% and 34.1%.The number of WML patients had statistically significant differences between A group and C group(χ2 =16.407,P <0.05),and B group and C group(χ2 =15.912,P <0.05).In A group,the TC levels in the moderate group [(4.45 ±1.07)mmol/L]and severe group[(5.04 ±0.99)mmol/L] were significantly higher than that in the mild group [(3.68 ±1.03)mmol/L],the difference was statistically significant(F =22.391,P <0.05);the LDL -C level in the severe group[(2.88 ±0.65)mmol/L]was significantly higher than (1.98 ±0.84)mmol/L in the mild group and (2.33 ±0.89)mmol/L in the moderate group(F =14.764,P <0.05).In B group,the TC levels in the moderate group [(4.79 ±1.38)mmol/L]and the severe group [(5.20 ±1.43)mmol/L]were significantly higher than (3.85 ±1.16)mmol/L in the mild group,the difference was statistically significant(F =20.515,P <0.05).Compared with the mild group[(2.13 ±0.83)mmol/L],the LDL –C level was higher in the severe group[(2.81±1.01)mmol/L],the difference was statistically significant(F =9.235, P <0.05).In C group,the levels of TC and LDL -C in the moderate group were (3.94 ±1.22)mmol/L and (2.02 ± 0.74)mmol/L,respectively,which in the severe group were (3.93 ±1.16)mmol/L and (2.30 ±0.85)mmol/L,respectively,which were significantly higher than those in the mild group [(3.12 ±1.34 )mmol/L,(1.62 ±0.88)mmol/L],the differences were statistically significant(F =27.141,27.078,all P <0.05).Spearman correlation analysis showed that there was a positive correlation between hypertension,TC,LDL -C and the severity of WML(H type hypertensionr =0.211,P <0.05;TCr =0.266,P <0.05;LDL -Cr =0.258,P <0.05).Conclusion H type hypertension and high levels of TC,LDL -C can increase the number and severity of WML.