Association Between D-dimer、cystatin C And Carotid Arterial Remodeling In Patients With High-normal Blood Pressure And Hyperhomochysteinemia

Objective:To observe and study the association between D-dimer、cystatin C and carotid arterial remodeling in patients with high-normal blood pressure and hyperhomochysteinemia.Methods:We studied 145 high-normal blood pressure patients and 141 high-normal blood pressure patients with hyperhomochysteinemia. Color flow Doppler sonography was used to measure Carotid intima-media thickness. low density lippprotein cholesterol(LDL-C),triglyceride(TG),high density lippprotein cholesterol(HDL-C),fast plasma glucose(FPG),total cholesterol(TC), homocysteine(Hcy),D-dimer and cystatin C(Cys C) were detected.Results:1、Compared to patients with high-normal blood pressur, patients with high-normal blood pressure and HHcy had higher level of D-dimer、Cys C and FPG[(163.65±62.77)vs(126.63±52.20)ng/L,(1.40±0.30)vs(1.04±0.15)mg/L,(6.33±2.39)vs(5.34±1.53)mmol/L,P<0.05],and thicker C-IMT[(1.50±0.62)vs(1.09±0.32)mm,P<0.05]2、In high-normal blood pressure patients, the thickened C-IMT group,compared to the normal C-IMT group,had more smoker and lower level of HDL-C [( 34(32.7))vs3(7.3)numer(%),(0.95±0.18)vs t(1.26±0.29)mmol/L,P<0.05].3、In high-normal blood pressure patients with HHcy,Compared to the normal C-IMT group,the thickened C-IMT group had higher level of Cys C、D-dimer、LDL-C and diastolic blood pressure[( 1.50±0.27) vs( 1.11±0.15) mg/L,( 177.51±62.02) vs(126.91±51.33)ng/L,(2.80±0.87)vs(2.15±0.79)mmol/L,(75.75±5.88)vs(72.70±5.35)mm Hg,P<0.05].4、In high-normal blood pressure patients, C-IMT was only positively correlated with course and age( r=0.231,0.222,P <0.05).In high-normal blood pressure patients with HHcy,C-IMT was obviously correlated with course,Cys C,D-dimer and TC(r=0.193,0.207,0.226,0.186,0.317,all P <0.05).5 、 In multivariate factor regression model,C-IMT was obviously and gradually associated with D-dimer(B=0.881,P <0.05)、 Cys C(B=0.197,P <0.05)、age(B=0.003,P<0.05)in group with HHcy and high-normal blood pressure.At the same time,C-IMT was just obviously associated with age( B=0.002,P <0.05) in high-normal blood pressure patients.Conclusion:Compared to group with high-normal blood pressure,high-normal blood pressure patients with HHcy group had higher level of D-dimer、Cys C and thicker C-IMT,which indicated that HHcy might accelerate the damage of C-IMT. Moreover,C-IMT was significantly and gradually associated with D-dimerand Cys C in patients with HHcy and high-normal blood pressure.It suggested that D-dimer and Cys C were independent predictors of C-IMT in patients with HHcy and high-normal blood pressure.