Study On The Correlation Between MPV/PLT,Serum Total Bilirubin Level And Left Ventricular Hypertrophy In Patients With H-type Hypertension

Objective To investigate the relationship between the ratio of mean platelet volume to platelet count（MPV/PLT）,serum total bilirubin（TBIL）level and left ventricular mass index(（LVMI）in hypertensive patients with hyperhomocysteine（Hhcy）.Methods In strict accordance with the inclusion and exclusion criteria,207patients with type H hypertension were enrolled.All subjects were examined by homocysteine（Hcy）,mean platelet volume,platelet count,serum total bilirubin and cystatin-C,and improved cardiac color ultrasound.According to the results of color Doppler echocardiography,all hypertensive patients with HHcy（≥10umol/L）were divided into left ventricular hypertrophy group（group A）and non-left ventricular hypertrophy group（group B）according to LVMI.SPSS25.0 software was used for statistical analysis.Results（1）It was found that the level of Hcy in two groups,group A was higher than that in group B（P>0.05）,and there was no significant difference in sex,age,BMI,smoking history,drinking history and family history of hypertension between the two groups（P>0.05）.（2）The levels of MPV/PLT,TBIL,DBIL and IBIL in group B were higher than those in group A（P<0.05）,and the difference was statistically significant.（3）There was no significant difference in DBP,Neut,Cr,TC,LDL,APOB,Alp,PDW,ALT,Lym,FPG,APOB/APOA-1,phospholipid,serum potassium,CIMT,CK-MB,HDL and lipoprotein a between the two groups（P>0.05）,but there was significant difference in SBP,APOA-1,LVMI,CYS-C,RBP,NLR and CRP between the two groups（P<0.05）.（4）Binary Logistic regression showed that CRP,NLR,DBIL,Apo A-1,age,sex,family history,smoking history,drinking history and CTMT levels had no significant effect on ventricular hypertrophy in patients with type H hypertension（P>0.05）,while the levels of SBP,MPV/PLT,TBIL,IBIL,CYS-C and RBP had significant effects on ventricular hypertrophy in patients with type H hypertension（P<0.05）,the OR values were 0.970,1.513*10¹²,1.124,1.147,0.245 and1.052,the difference was statistically significant.（5）There was no correlation between RBP and LVMI（P>0.05）.SBP and CYS-C were positively correlated with LVMI（r=0.182 and 0.229,P<0.05）.There was a negative correlation between MPV/PLT,TBIL,IBIL and LVMI（r=-0.156,-0.332,-0.262,P<0.05）.（6）The ROC curve area（AUC）of MPV/PLT for diagnosing H-type hypertension with LVH was 0.618,the sensitivity of 86%and a specificity of 34%.The AUC of TBIL for diagnosing H-type hypertension with LVH was 0.813,the sensitivity was 80%,and the specificity was 71%.There was significant difference in AUC between MPV/PLT and TBIL in the diagnosis of H-type hypertension with LVH（P<0.05）.When TBIL and IBIL were combined to diagnose H-type hypertension with LVH,the AUC of TBIL+IBIL increased to 0.825（P<0.05）,and the difference was statistically significant.Conclusion（1）Low levels of MPV/PLT and TBIL may reduce the risk of LVH in patients with H-type hypertension;（2）MPV/PLT may have certain diagnostic value in the occurrence of LVH in patients with H-type hypertension;（3）TBil level has predictive value for the occurrence of LVH in patients with H-type hypertension;（4）TBIL combined with IBIL can further improve the prediction of LVH in patients with H-type hypertension;（5）SBP,Cys-C and LVMI are risk factors for LVH in patients with H type hypertension.