高血压心血管危险分层与左室舒张功能障碍及NT-proBNP的相关性研究
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摘要
目的分析左室舒张功能障碍及N端脑肽钠前体(NT-pro BNP)等相关指标与高血压患者心血管危险分层的相关性。方法根据我国高血压防治指南对于高血压心血管危险分层的标准,将2012年1月至2014年1月接受治疗154例高血压患者分为极高危组(34例)、高危组(36例)、中危组(40例)以及低危组(44例),另选取同期进行体检的健康志愿者40例作为对照组,分析各个组之间左室舒张功能及NT-pro BNP等指标的变化及相关性。结果由于本研究各项指标均不满足正态分布的规律,故采用Spearman秩相关分析检验各个指标之间的相关性,结果发现除了E波衰减时间(DCT)与左室等容舒张时间(IVRT)、左室重量指数(LVMI)与IVRT无明显的线性关系外,其他各项指标之间均呈现线性关系。采用Mann-Whitney非参数检验,结果发现除了DCT与IVRT两组之间无显著差异外,其他各项指标均有显著性差异,其中LVMI以及NT-pro BNP高血压组均显著大于对照组。采用Mann-Whitney非参数检验,结果发现除了DCT与IVRT两组之间无显著差异外,其他各项指标均有显著性差异,其中LVMI以及NT-pro BNP高血压组均显著大于对照组。经Spearman秩相关分析发现,除了DCT与组别危险程度无相关性外,其他各指标与组别程度均具有明显的相关性。结论高血压患者随着心血管危险分层的逐渐提高,NT-pro BNP水平也之间升高。检测NT-pro BNP水平有助于对高血压患者进行心血管危险分层。
Objective To explore the correlation between left ventricular diastolic dysfunction and NT- pro BNP and other related indexes and cardiovascular risk stratification in patients with hypertension. Methods From January 2012 ~ 2014 in January,we treated 154 patients with hypertension. According to the guidelines of hypertension prevention and control for hypertension and cardiovascular risk stratification standard,patients were divided into high risk group( 34 cases),high risk group( 36 cases) and intermediate risk group( 40 cases) and low risk group( 44cases). At the same time,we selected another 40 cases from the hospital for examination of normal volunteers as the control group. The analysis of the changes and correlation of the correlation index between the various groups were performed. Results The indexes in this study did not satisfy the law of normal distribution,therefore the Spearman rank correlation analysis was performed between each index of correlation. The results showed that LVMI and IVRT did not have obvious linear relationship in addition to the DCT and IVRT. Other indicators showed a linear relationship by the Mann Whitney nonparametric test. The results showed that no significant difference was found in addition to the DCT and IVRT between the two groups. The other indicators were significantly different. LVMI and NT pro BNP in hypertension group were significantly higher than that of the control group using the Mann Whitney nonparametric test. The results showed that no significant difference was found between the two groups in addition to the DCT and IVRT. The other indicators were significantly different. LVMI and NT pro BNP in hypertension group were significantly higher than that of the control group. The Spearman rank correlation analysis found that the DCT and group risk degree had no correlation,other indexes and group level has obvious correlation. Conclusion Hypertensive patients with a gradual increase in cardiovascular risk stratification,NT pro BNP levels were also elevated in hypertensive patients of cardiovascular risk stratification. This index has important significance in disease control,it is worth in clinical promotion.
Objective To explore the correlation between left ventricular diastolic dysfunction and NT- pro BNP and other related indexes and cardiovascular risk stratification in patients with hypertension. Methods From January 2012 ~ 2014 in January,we treated 154 patients with hypertension. According to the guidelines of hypertension prevention and control for hypertension and cardiovascular risk stratification standard,patients were divided into high risk group( 34 cases),high risk group( 36 cases) and intermediate risk group( 40 cases) and low risk group( 44cases). At the same time,we selected another 40 cases from the hospital for examination of normal volunteers as the control group. The analysis of the changes and correlation of the correlation index between the various groups were performed. Results The indexes in this study did not satisfy the law of normal distribution,therefore the Spearman rank correlation analysis was performed between each index of correlation. The results showed that LVMI and IVRT did not have obvious linear relationship in addition to the DCT and IVRT. Other indicators showed a linear relationship by the Mann Whitney nonparametric test. The results showed that no significant difference was found in addition to the DCT and IVRT between the two groups. The other indicators were significantly different. LVMI and NT pro BNP in hypertension group were significantly higher than that of the control group using the Mann Whitney nonparametric test. The results showed that no significant difference was found between the two groups in addition to the DCT and IVRT. The other indicators were significantly different. LVMI and NT pro BNP in hypertension group were significantly higher than that of the control group. The Spearman rank correlation analysis found that the DCT and group risk degree had no correlation,other indexes and group level has obvious correlation. Conclusion Hypertensive patients with a gradual increase in cardiovascular risk stratification,NT pro BNP levels were also elevated in hypertensive patients of cardiovascular risk stratification. This index has important significance in disease control,it is worth in clinical promotion.
引文
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[11]毛山,胡学宁,王崇全.血浆N端脑钠肽前体与老年慢性心力衰竭患者心功能的关系研究[J].临床和实验医学杂志,2013,12(9):689-690.
[12]严军虎,张淑娟.硝苯地平联合瑞舒伐他汀对老年高血压病患者血压、血脂及颈动脉内膜中层厚度的影响[J].陕西医学杂志,2014,19(6):749-751.
[2]李文静,庄义浩,唐悌,等.心血管脑卒中高危人群预防危险评估及分层治疗效果比较[J].中国现代医生,2014,52(15):150-153.
[3]李盈.高血压患者心血管病发病风险及多重危险因素的研究[C].天津:天津医科大学,2013.
[4]刘力生.中国高血压防治指南2010[M].北京:人民卫生出版社,2012.
[5]陆凤,赵鸣,胡如英,等.浙江省高血压患者心血管病危险分层评估现状分析[J].中华流行病学杂志,2014,35(11):1231-1234.
[6]刘东云,郭雪微,鲍艳江,等.北京局部地区农村老年高血压患者危险分层评估[J].中国循证心血管医学杂志,2014,51(4):400-403.
[7]蓝剑,吴锦霞,张雪姣,等.高血压社区分级防治管理模式的实践效果评价[J].中国慢性病预防与控制,2014,22(2):213-214.
[8]林细明,邹容.荔城社区高血压危险分层及综合防治策略研究[J].中国医药导报,2014,7(17):128-130.
[9]张国华,郑素君,郑海澜,等.SWI评估高血压患者心血管危险分层与脑内微出血相关性的研究[J].医学影像学杂志,2014,24(1):25-28.
[10]王利平.对高血压患者心血管危险性分层及治疗情况进行探究和分析[J].医学信息,2014,3(26):547-548.
[11]毛山,胡学宁,王崇全.血浆N端脑钠肽前体与老年慢性心力衰竭患者心功能的关系研究[J].临床和实验医学杂志,2013,12(9):689-690.
[12]严军虎,张淑娟.硝苯地平联合瑞舒伐他汀对老年高血压病患者血压、血脂及颈动脉内膜中层厚度的影响[J].陕西医学杂志,2014,19(6):749-751.