中文摘要：

目的揭示高血压患者同型半胱氨酸与冠心病的关系。方法采用前瞻性队列研究设计,对深圳市南山区60个社区的5488名高血压患者进行基线调查和平均2.7年随访。Hcy采用循环酶法进行检测。结果 5488名高血压人群327人失访,失访率为5.96%,新发冠心病患者157人,累积发病率3.04%。在未矫正传统危险因素时,高Hcy血症引发冠心病的风险（Hazard Ratio,HR）在女性中为2.26（1.40-3.64）,但在矫正年龄、性别、教育、吸烟、饮酒、BMI、体育锻炼、糖尿病、抑郁、冠心病家族史、患病年限、降压药、叶酸、收缩压、总胆固醇、血糖和甘油三酯后,Hcy最高四分位数Q4与最低四分位数Q1相比,Hcy引发冠心病的HR为1.18（0.59-1.63）,在男性和女性中分别为1.35（0.53-2.73）和1.02（0.53-1.97）,均无统计学意义,且未发现Hcy与心血管疾病传统危险因素对冠心病具有一级交互作用（所有P〉0.05）。结论在矫正传统心血管危险因素后,我们未发现高血压患者中Hcy和冠心病的关联具有统计学意义。

英文摘要：

Objective To analyze the association between homocysteine（Hcy） and coronary heart disease（CHD） in hypertensive patients.Methods This study was a prospective cohort study,and we conducted a baseline survey in 5488 patients with hypertension from 60 communities of Nanshan District,Shenzhen.We followed up the patients for an average of 2.7 years.Hcy was detected by enzymatic cycling method.Results 5488 hypertensive populations were followed up for an average of 2.7 years,327 people lost（5.96%）.157 were new CHD patients,with the incidence of 3.04%.The primary HR（95% CI） of hyperhomocysteinemia for CHD in women was 2.26（1.40-3.64）.After adjusted for age,sex,education,smoking,alcohol drinking,and BMI,also adjusted for physical activity,diabetes,depression,family history of coronary heart disease,years of hypertension,antihypertensive drugs,folic acid,SBP,TC,Glu and TG,the HR（95% CI） for CHD,highest quartile of Hcy（Q4） compared to Q1 was not statistically significant,1.18（0.59-1.63） in total,1.35（0.53-2.73）in men and 1.02（0.53-1.97） in women.No significant interactions between homocysteine and the above stratified factors on the presence of CHD were found（P〉 0.05）.Conclusion After adjusted for the traditional cardiovascular factors,we did not find significant correlation between Hcy and prevalence of CHD in hypertensive patients.