| Objective: To investigate the relationship of serum homocysteine(Hcy)and high sensitivity C-reactive protein(hs-CRP)with carotid intima-media thickness(IMT)and plaque Crouse score in hypertensive patients.To provide experimental basis for clinical evaluation of pronosis in hypertensive patients.Methods:116 hypertensive patients,who were admitted to the cardiology and neurology departments,Xiangtan Hospital Affiliated to University of South China from August 2016 to March 2017,were divided into the H-type hypertension group(Hcy?10?mol/L,n=96,H group)and the simple hypertension group(Hcy<10?mol/L,n=20,simple group).At the same time,25 individuals receiving physical examination without hypertension in our medical center were selected as the control group.Venous blood was sampled in all subjects for laboratory biochemical tests,including total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),homocysteine(Hcy)and high sensitivity C-reactive protein(hs-CRP),the results of which were recorded.At the same time,cervical vascular color Doppler ultrasonography was performed in all subjects to measure IMT of carotid vessels.For the patients with bilateral carotid artery plaque formation,the location,number,size and echo characteristics of these plaques were accurately described.The H group/ the simple group vs.the control group were compared in terms of Hcy,hs-CRP,carotid IMT,plaque formation and Crouse score;the correlation of them was analyzed in hypertension patients.Results:1.The differences in age,HDL-C,hs-CRP,IMT and plaque formation were statistically significant between the hypertensive group and the control group(P<0.01),while no statistically significant differences were reported between them in gender,history of tobacco use,history of alcohol use,family history of stroke,BMI,TC,LDL-C,TG and Hcy(P>0.05).2.The differences in age,FBG and IMT were statistically significant between the H group/the simple group vs.the control group(P<0.05);the differences in HDL-C,hs-CRP and plaque formation were statistically significant between the H group and the control group(P<0.05);the difference in Hcy was statistically significant between the simple group and the control group(P<0.05).No statistically significant differences were observed between three groups in gender,BMI,TC,LDL-C and TG(P>0.05).3.A total of 105 plaques were detected from 141 subjects,where stable plaques found the highest incidence(86 lesions).The carotid sinus suffered most plaque development(76lesions)and accounted for 74.2% of all lesions developed at different sites in hypertension group.4.The differences in gender,age,DBP,HDL-C,Hcy and IMT were statistically significant between the atherosclerosis group and the non-arteriosclerosis group in 116 hypertensive patients(P?0.01),while the difference in BMI,SBP,hypertension duration,TC,LDL-C,TG,FBG and hs-CRP was not statistically significant(P>0.05).After Two categories logistic regression analysis,the independent risk factors of carotid atherosclerosis were followed by IMT(OR1.191E10,95%CI: 46622.772-3.041E15,P=0.000)?gender(OR 5.328,95%CI: 1.812-15.664,P =0.002)in hypertensive patients?After multiple linear regression analysis,the influence factors of IMT were followed by Hcy(?=0.249,P<0.01)?age(?=0.219,P<0.05).The differences in DBP and IMT were statistically significant between the atherosclerosis group and the non-arteriosclerosis group in hypertensive patients less than 65 years old.(P < 0.05).After two categories logistic regression analysis,the independent risk factors of carotid atherosclerosis was IMT(OR1.690E8,95%CI:91.228-3.131E14,P=0.010)in hypertensive patients less than 65 years old.5.The difference in Crouse score was statistically significant between the unstable plaque group and the stable plaque group in hypertensive patients(P<0.05),while the differences in Hcy,hs-CRP and IMT were not statistically significant(P>0.05).6.In 116 hypertensive patients,serum Hcy was not significantly correlated with hs-CRP(r=0.036,P>0.05)but showed a significant positive correlation with IMT(r=0.264,P<0.01);no significant correlation was observed between Hcy and Crouse score(r=0.25,P>0.05);there was no significant correlation between serum hs-CRP and IMT(r=-0.032,P>0.05)as well as between hs-CRP and Crouse score(r=0.002,P>0.05).IMT was not significantly correlated with DBP(r=-0.010,P>0.05)but showed a significant positive correlation with age(r=0.176,P<0.05)and a significant negative correlation with HDL-C(r=-0.185,P<0.05).Conclusion:1.Elevated hs-CRP suggests a mild inflammatory response in H-type hypertensive patients.2.IMT and male are independent risk factors for carotid atherosclerosis in hypertensive patients.Crouse score is associated with the plaque stability in hypertensive patients. |
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