高血压患者主动脉脉搏波传导速度影响因素探究
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摘要
目的:分析原发性高血压(EH)患者主动脉脉搏波传导速度(APWV)的影响因素。方法:我院336例EH患者被分为APWV升高组(281例)和APWV正常组(55例),对比两组临床资料,采用Logistic多元回归分析EH患者APWV的影响因素。结果:与APWV正常组比较,APWV升高组年龄[(56.71±11.45)岁比(62.98±12.36)岁],糖尿病(5.45%比19.22%)、肥胖(18.18%比23.84%)、吸烟史(16.36%比30.60%)、高血压3级(12.73%比32.03%)比例,人体质量指数(BMI)[(22.53±2.07)kg/m~2比(23.28±2.04) kg/m~2],SBP[(139.64±12.85)mmHg比(147.39±13.30)mmHg]、DBP[(93.18±8.73)mmHg比(96.43±9.14)mmHg],TC[(5.18±0.91)mmol/L比(5.65±1.03)mmol/L]、LDL-C[(3.00±0.68)mmol/L比(3.24±0.72)mmol/L]、SCr[(110.71±52.39)μmol/L比(138.52±63.65)μmol/L]、SUA[(318.73±102.62)μmol/L比(354.28±108.35)μmol/L]水平显著升高,HDL-C(1.19±0.32)mmol/L比(1.09±0.30)mmol/L显著降低(P<0.05或<0.01)。多因素Logistic回归分析显示,年龄、糖尿病、SBP、TC、SCr、高血压等级是影响APWV的独立危险因素(OR=2.826～3.732,P均<0.05)。结论:年龄、糖尿病、SBP、TC、SCr、高血压等级是影响原发性高血压患者APWV的危险因素,因此,应采取相应的防治措施改善预后。
Objective:To analyze influencing factors of aortic pulse wave velocity(APWV) in patients with essential hypertension(EH).Methods:The 336 EH patients from our hospital were divided into elevated APWV group(n=281) and normal APWV group(n=55). Clinical data were compared between two groups, and multi-factor Logistic regression was used to analyze influencing factors of APWV in EH patients.Results:Compared with normal APWV group, there were significant rise in age [(56.71±11.45) years vs.(62.98±12.36)years], percentages of diabetes mellitus(5.45% vs. 19.22%), obesity(18.18%vs. 23.84%), smoking(16.36% vs. 30.60%),EH stage 3(12.73% vs. 32.03%), body mass index [BMI,(22.53±2.07)kg/m~2 vs.(23.28±2.04) kg/m~2], systolic blood pressure SBP[(139.64±12.85)mmHg vs.(147.39±13.30)mmHg], diastolic blood pressure DBP[(93.18±8.73)mmHg vs.(96.43±9.14)mmHg], TC[(5.18±0.91)mmol/L vs.(5.65±1.03)mmol/L], LDL-C[(3.00±0.68)mmol/L vs.(3.24±0.72)mmol/L], serum creatinine SCr[(110.71±52.39)μmol/L vs.(138.52±63.65)μmol/L], serum uric acid SUA[(318.73±102.62)μmol/L vs.(354.28±108.35)μmol/L], and significant reduction in level of HDL-C[(1.19±0.32)mmol/Lvs.(1.09±0.30)mmol/L]in elevated APWV group, P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated that age, diabetes mellitus, SBP, TC, SCr and EH stage were independent risk factors for APWV(OR=2.826-3.732,P<0.05 all).Conclusion:Age, diabetes mellitus, SBP, TC, SCr and EH stage are risk factors for APWV in EH patients. Therefore, corresponding preventive and therapeutic measures should be taken to improve prognosis.
Objective:To analyze influencing factors of aortic pulse wave velocity(APWV) in patients with essential hypertension(EH).Methods:The 336 EH patients from our hospital were divided into elevated APWV group(n=281) and normal APWV group(n=55). Clinical data were compared between two groups, and multi-factor Logistic regression was used to analyze influencing factors of APWV in EH patients.Results:Compared with normal APWV group, there were significant rise in age [(56.71±11.45) years vs.(62.98±12.36)years], percentages of diabetes mellitus(5.45% vs. 19.22%), obesity(18.18%vs. 23.84%), smoking(16.36% vs. 30.60%),EH stage 3(12.73% vs. 32.03%), body mass index [BMI,(22.53±2.07)kg/m~2 vs.(23.28±2.04) kg/m~2], systolic blood pressure SBP[(139.64±12.85)mmHg vs.(147.39±13.30)mmHg], diastolic blood pressure DBP[(93.18±8.73)mmHg vs.(96.43±9.14)mmHg], TC[(5.18±0.91)mmol/L vs.(5.65±1.03)mmol/L], LDL-C[(3.00±0.68)mmol/L vs.(3.24±0.72)mmol/L], serum creatinine SCr[(110.71±52.39)μmol/L vs.(138.52±63.65)μmol/L], serum uric acid SUA[(318.73±102.62)μmol/L vs.(354.28±108.35)μmol/L], and significant reduction in level of HDL-C[(1.19±0.32)mmol/Lvs.(1.09±0.30)mmol/L]in elevated APWV group, P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated that age, diabetes mellitus, SBP, TC, SCr and EH stage were independent risk factors for APWV(OR=2.826-3.732,P<0.05 all).Conclusion:Age, diabetes mellitus, SBP, TC, SCr and EH stage are risk factors for APWV in EH patients. Therefore, corresponding preventive and therapeutic measures should be taken to improve prognosis.
引文
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[12]中华预防医学会慢性病预防与控制分会,中国心血管健康联盟.四个学术团体联合发布“正确认识胆固醇的科学声明”[J].营养学报,2016,38(5):419-420.
[2]梅艳,倪淑明,李治国.原发性高血压患者心血管危险因素对动脉弹性的影响[J].中国现代医学杂志,2016,26(2):94-97.
[3]Meyer ML,Tanaka H,Palta P,等.中心和外周动脉脉搏波传导速度测量的重复性:社区动脉粥样硬化风险研究[J].中华高血压杂志,2016,24(5):498-498.
[4]刘力生.中国高血压防治指南2010[J].中华高血压杂志.
[5]邓阳生,刘全未,赵增光.原发性高血压患者心血管风险水平分层研究[J].中国现代医学杂志,2016,26(4):133-137.
[6]Lee DH,Youn HJ,Chung WB,et al.Effects of metabolic syndrome on aortic pulse wave velocity[J].Clinical Hypertension,2017,23(1):1.
[7]Willumhansen T,Staessen J A,Torppedersen C,et al.Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population[J].Circulation,2006,113(5):664.
[8]刘莉,叶鹏,Szmigielski C,等.脉搏波传导速度与以食管超声心动图评估的主动脉粥样硬化相关[J].中华高血压杂志,2015,23(5):491-491.
[9]张鑫,洪必莹,陈晓平,等.不同性别高血压患者脉搏波传导速度影响因素研究[J].西部医学,2016,28(3):346-350.
[10]王宏宇,倪永斌,龚兰生,等.老年高血压患者大动脉弹性研究[J].中国老年学杂志,2003,23(1):10-12.
[11]梅艳,倪淑明,李治国.原发性高血压患者心血管危险因素对动脉弹性的影响[J].中国现代医学杂志,2016,26(2):94-97.
[12]中华预防医学会慢性病预防与控制分会,中国心血管健康联盟.四个学术团体联合发布“正确认识胆固醇的科学声明”[J].营养学报,2016,38(5):419-420.