Abstract：【Objective】 To investigate the correlation between serum homocysteine (Hcy) level and cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients. 【Methods】 Seventy-nine patients with hypertension emergency and sub emergency were selected were enrolled in the study The serum Hcy level was detected to evaluate the occurrence of cardio cerebral atherosclerosis. The patients with cardio cerebral atherosclerosis were the observation group (n=48),and the patients without cardio cerebral atherosclerosis were the control group (n=31). The general data and serum Hcy level of the two groups were compared,and the influencing factors of cardio cerebral atherosclerosis were analyzed by logistic regression; ROC was used to evaluate the predictive value of serum Hcy level in cardio cerebral atherosclerosis. 【Results】 There were no significant differences in terms of sex,age,BMI,smoking history,diabetes,hyperlipidemia,FPG,HbAlc,LDL-C,HDL-C between the two groups (P>0.05). The proportion of previous PCI history,cerebral infarction history,Cr,BUN,Gensini score and Hcy level in the observation group were higher than those in the control group (P<0.05). Logistic regression analysis showed that previous PCI history,cerebral infarction history,BUN,Gensini score and Hcy were the influencing factors of cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients (P<0.05). ROC analysis showed that the cut-off value of serum Hcy level in hypertensive emergency and sub emergency patients for the diagnosis of cardio cerebral atherosclerosis was 8.76 μmol/L and the AUC value was 0.974,with the sensitivity of 89.58% and specificity of 96.77%. 【Conclusion】 There is a close correlation between serum Hcy level and cardio cerebral atherosclerosis in hypertensive emergency and sub emergency patients,which can provide useful reference for clinical diagnosis and treatment.
[1] DI PALO K E,BARONE N J. Hypertension and heart failure:prevention,targets,and treatment[J].Heart Fail Clin,2020,16(1):99-106. [2] 吴晓飞.高血压急症识别与处理[J].中华全科医学,2021,19(1):4-5. [3] KAPLAN P,TATARKOVA Z,SIVONOVA M K,et al. Homocysteine and mitochondria in cardiovascular and cerebrovascular systems[J].Int J Mol Sci,2020,21(20):7698. [4] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会中国医师协会高血压专业委员会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56. [5] 杨文慧,杨莉,何燕,等.外周动脉粥样硬化与冠状动脉病变Gensini评分的相关性[J].中国老年学杂志,2015,10(9):2391-2393. [6] 华扬,高山,吴钢,等.经颅多普勒超声操作规范及诊断标准指南[J].中华医学超声杂志(电子版),2008,5(2):197-222. [7] 杨升华,韩雪洁,胡宏宇,等.可溶性晚期糖基化终末产物受体与心脑动脉粥样硬化的相关性[J].中华医学杂志,2019,99(39):3062-3067. [8] LEE J H,KIM K I,CHO M C. Current status and therapeutic considerations of hypertension in the elderly[J].Korean J Intern Med,2019,34(4):687-695. [9] DONG X J,WANG B B,HOU F F,et al. Homocysteine (HCY) levels in patients with atrial fibrillation (AF):A meta-analysis[J].Int J Clin Pract,2021,75(12):e14738. [10] 于骁,邓伟,高宇,等.老年脑梗死患者血清Hcy、UA水平与颈动脉粥样硬化的关系[J].中国实验诊断学,2021,25(3):381-383. [11] AZZINI E,RUGGERI S,POLITO A. Homocysteine:Its possible emerging role in at-risk population groups[J].Int J Mol Sci,2020,21(4):1421. [12] KOKLESOVA L,MAZURAKOVA A,SAMEC M,et al. Homocysteine metabolism as the target for predictive medical approach,disease prevention,prognosis,and treatments tailored to the person[J].EPMA J,2021,12(4):477-505. [13] CAO Y.Correlation between total homocysteine and cerebral small vessel disease:A Mendelian randomization study[J].Eur J Neurol,2021,28(6):1931-1938.
2023, Vol. 40 
