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1、福建医科大学硕士学位论文5.多元线性回归分析显示:IMT、LVMI、脑血管病变、Scr与Hcy呈正相关;eGFR与Hcy、nSCV呈负相关,与dDBP呈正相关;LVMI与nSSD呈正相关,与eGFR、nSCV呈负相关。6.Logistic回归分析显示:Hcy与nDSD对LVMI存在叠加作用,Hcy与dDCV对UAlb存在叠加作用,24hSBP、dSBP、dDCV与Hcy对eGFR存在叠加作用。结论:1.高血压患者的靶器官损害与短时的血压变异性呈现一定的相关性。2.H型高血压患者中血浆同型半胱氨酸水平升高是高血压靶器官损害的一个重要影响因素,血浆Hcy水平与发生靶器官损害的风
2、险呈正相关。3.24h平均收缩压与白昼平均收缩压与Hcy对H型高血压患者的肾功能损害方面具有叠加效应。4.部分增加的血压变异性和Hcy对H型高血压患者的心、肾功能损害呈现出叠加效应。关键词:H型高血压,同型半胱氨酸,血压变异性,靶器官损害5福建医科大学硕士学位论文AclinicalstudyofrelationshipbetweenbloodpressurevariabilityandtargetorgandamageinH-typehypertensivepatientsAbstractObjective:Tostudytherelationshipbetweenbloo
3、dpressurevariabilityandrelatedtargetorgansdamageintheH-typehypertensivepatients,inordertodemonstratethesynergisticeffectsofhomocysteineandthebloodpressurevariabilityontargetorgandamageinthehypertensivepatients.Methods:174essentialhypertensivepatientswereenrolledinourstudyfrom2013.1to2014.1
4、2,and52healthsubjectswereservedascontrols.AccordingtothelevelofserumHcy,allthehypertensivepatientsweredividedintotwogroups:highhomocysteinehypertensivegroup(HHgroup,Hcy>10μmol/L,n=89)andnormolhomocysteinehypertensivegroup(NHgroup,Hcy<10μmol/L,n=85).Allpatientswererequiredtomeasureheight,bo
5、dyweight,bloodpressure,bloodliverandrenalfunctiontests,serumlipid,fastingplasmaglucose,homocysteine(Hcy),urinaryalbumin,estimateglomerularfiltrationrate.Allsubjectswereunderwentambulatorybloodpressuremonitoring,andrecord:24houraveragesystolicbloodpressure,24houraveragediastolicbloodpressur
6、eandthecorrespondingstandarddeviation;dayaveragesystolicbloodpressure,dayaveragediastolicbloodpressureandthecorrespondingstandarddeviation;nightveragesystolicbloodpressure,nightaveragediastolicbloodpressureandthecorrespondingstandarddeviation,atthesametimetocalculatethecoefficientofvariati
7、onultrasound.Donetheechocardiographyexaminationandmeasuredleftventricularend-diastolicdimension(LVDd),interventricularseptalthickness(IVST)andleftventricularposteriorwallthickness(LVPWT),thencalculatedleftventricularmassindex(LVMI)wascalculated.Andultrasonogra