目的 为了探讨原发性高血压（essential hypertension，EH）伴脑出血患者测定血清生化指标和生物标志物水平的临床价值。方法 采用生化法，酶免疫分析和免疫透射比浊法测定257例单纯EH组和207例EH伴脑出血组患者血清TC（total cholesterol），TG(triglyceride)，HDL-C(high density lipoprotein-cholesterol)，LDL-C(low density lipoprotein-cholesterol)，Lp(a)[lipoprotein(a)]，FPG(fasting plasma glucose)和UA(uric acid)水平以及生物标志物HCy(homocysteine)，ATⅡ(angtiotensinⅡ)和cTnⅠ(cardiac troponin Ⅰ)水平并与61例正常对照组进行比较分析。结果207例EH伴脑出血组患者血清TC，TG，HDL-C，LDL-C和LP(a)水平较之257例单纯EH组明显增高[PTC<0.05，PTG<0.01，PLDL-C<0.05 和 PLp(a)<0.05]，EH伴脑出血组和单纯EH组均随E0、E1、E2和E3组的血压增高而增高，而血清HDL-C水平明显降低（P<0.05），随血压增高而降低。如以FPG组>6.1mmol/L为标准，257例单纯EH组糖代谢异常为38.5%，207例EH伴脑出血组为52.9%。207例伴脑出血组血清UA水平较之257例单纯EH组增高（P<0.05），两组均随血压的增高而增高。生物标志物中，207例EH伴脑出血组血清HCy，ATⅡ和cTnⅠ水平较之257例单纯EH组明显增高（P分别为<0.05、<0.05和<0.01）。两组均随血压的增高而增高，并以血清HCy和cTnⅠ水平增高最为显著。结论 EH伴脑出血患者具有血脂、糖和尿酸代谢紊乱的现象；生物标志物（HCy和cTnⅠ）是诊断EH伴脑出血的有价值指标。

Objective To explore the clinical value of detection of serum biochemical and biological markers levels in the patients with essential hypertension (EH) cerebral hemorrhage. Methods The serum levels of TC，TG，HDL-C，LDL-C and LP(a) or HCy，ATⅡand cTnⅠin 257 patients with single EH essential hypertension, in 207 patients with EH cerebral hemorrhage, and 61 controls were determined by biochemistry, enzyme immunoassay and immunoturbidimetry. Results The serum levels of TC，TG，LDL-C and LP(a) in 207 patients with EH cerebral hemorrhage were significantly higher than those in 257 patients with single EH [PTC<0.05, PTG<0.01, PLDL-C<0.05 and PLp(a)<0.05]. The serum levels of TC，TG，LDL-C and LP(a) in patients with EH cerebral hemorrhage and single EH were increased with blood pressure (E0，E1，E2 and E3). But the HDL-C level was low and decreased with blood pressure (E0，E1，E2 and E3). If FPG >6.1 mmol/L as standard, the glucose metabolic abnormal rate in 257 patients with single EH were 38.5%, but in 207 patients with EH cerebral hemorrhage were 52.9% (P<0.05). In biomarkers, the serum levels of HCy，ATⅡand cTnⅠin 207 patients with EH cerebral hemorrhage were significantly higher than those in 207 patients with single EH (P<0.05,<0.05 and <0.01 respectively), but were increased with blood pressure (E0，E1，E2 and E3)), and the HCy and cTnⅠ were significantly increased. Conclusion The blood lipid, glucose and UA in patients with EH cerebral hemorrhage are metabolism abnormal, the biomarkers of HCy and cTnⅠ could be used as valuable index in diagnosis of EH cerebral hemorrhage.