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中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 39 -43. doi: 10.3877/cma.j.issn.1674-0785.2018.01.007

所属专题: 文献

临床研究

初诊高血压患者颈动脉硬化相关危险因素分析
黄素兰1, 郭宁1, 张志翔1, 鲁祖建1, 葛良清1, 匡泽民2,(), 余振球2   
  1. 1. 415000 常德市第一人民医院心内科
    2. 100029 北京安贞医院高血压科
  • 收稿日期:2017-07-29 出版日期:2018-01-01
  • 通信作者: 匡泽民
  • 基金资助:
    首都医科大学基础临床科研合作基金课题(16JL42)

Risk factors for carotid atherosclerosis in patients with newly diagnosed hypertension

Sulan Huang1, Ning Guo1, Zhixiang Zhang1, Zujian Lu1, Liangqing Ge1, Zemin Kuang2,(), Zhenqiu Yu2   

  1. 1. Department of Cardiology, the First People′s Hospital of Changde, Changde 415000, China
    2. Department of Hypertension, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 10029, China
  • Received:2017-07-29 Published:2018-01-01
  • Corresponding author: Zemin Kuang
  • About author:
    Corresponding author: Kuang Zemin, Email:
引用本文:

黄素兰, 郭宁, 张志翔, 鲁祖建, 葛良清, 匡泽民, 余振球. 初诊高血压患者颈动脉硬化相关危险因素分析[J/OL]. 中华临床医师杂志(电子版), 2018, 12(01): 39-43.

Sulan Huang, Ning Guo, Zhixiang Zhang, Zujian Lu, Liangqing Ge, Zemin Kuang, Zhenqiu Yu. Risk factors for carotid atherosclerosis in patients with newly diagnosed hypertension[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(01): 39-43.

目的

探讨初诊高血压患者颈动脉硬化(CAS)与相关危险因素的关系,为临床干预和预防高血压患者颈动脉硬化提供依据。

方法

选择2014年7月至2016年5月在常德市第一人民医院心内科门诊年龄>18岁的初诊高血压患者513例,根据颈动脉超声结果将患者分为颈动脉硬化组和正常组,其分别为233例和280例。应用t检验观察并比较2组患者血糖血脂、肾功能、诊室血压、24 h动态血压、尿蛋白定量、心脏彩超等指标,然后采用Logistic回归分析分析颈动脉硬化与相关危险因素的相关性;分析2组患者靶器官损害情况,应用χ2检验比较2组左心室肥厚和尿微量白蛋白检出率。

结果

(1)颈动脉硬化组患者的年龄、空腹血糖、24 h脉压、夜间脉压和白昼舒张压均高于正常组,差异有统计学意义(t=6.47,P<0.001;t=2.60,P=0.035;t=1.13,P=0.034;t=0.79,P=0.008;t=0.34,P<0.001)。(2)年龄是初诊高血压患者发生颈动脉硬化的危险因素(β>0,OR>1,P<0.001),高密度脂蛋白(HDL)则是颈动脉硬化的保护因素(β<0,OR<1,P=0.019)。(3)颈动脉硬化组左心室肥厚和尿微量白蛋白检出率均明显高于颈动脉正常组(χ2=13.17,P<0.001;χ2=9.80,P=0.002)。

结论

年龄为颈动脉粥样硬化独立的危险因素,而HDL水平越高对颈动脉的保护作用越好。

Objective

To identify the risk factors for carotid arteriosclerosis in patients with newly diagnosed hypertension to provide a basis for the prevention of carotid arteriosclerosis in these patients.

Methods

A total of 513 patients (aged over 18 years) with newly diagnosed hypertension at our hospital were included in this study. According to color Doppler ultrasound results, the patients were divided into either a carotid arteriosclerosis group (n = 233) or a non-carotid arteriosclerosis group (n = 280). Fasting blood glucose, blood lipids, renal function, blood pressure, 24-hour ambulatory blood pressure, cardiac ultrasound, and microalbuminuria were compared between the two groups by t-test. Then, logistic regression analysis was performed to identify the risk factors for carotid arteriosclerosis. The detection rates of left ventricular hypertrophy and microalbuminuria were compared between the two groups by χ2 test.

Results

Age, blood glucose, 24-h pulse pressure, nighttime pulse pressure, and daytime diastolic blood pressure were significantly higher in the carotid arteriosclerosis group than in the non-carotid arteriosclerosis group (t = 6.47, P<0.001; t = 2.60, P = 0.035; t = 1.13, P = 0.034; t = 0.79, P = 0.008; t = 0.34, P<0.001, respectively). Age was identified to be a risk factor (β>0, OR>1, P<0.001) and HDL was identified to be a protective factor (β<0, OR<1, P = 0.019) for carotid arteriosclerosis. The detection rates of left ventricular hypertrophy and microalbuminuria were significantly higher in the carotid arteriosclerosis group than in the non-carotid arteriosclerosis group (χ2 = 13.17, P = 0.000; χ2 = 9.80, P = 0.002).

Conclusion

Age can increase the risk of carotid arteriosclerosis in patients with newly diagnosed hypertension. HDL has a protective effect against carotid arteriosclerosis.

表1 颈动脉正常组和硬化组患者临床资料比较
表3 颈动脉硬化的单因素分析
表4 颈动脉硬化相关因素赋值表
表5 颈动脉硬化相关危险因素的多因素Logistic回归分析
表2 颈动脉正常组和硬化组各项血压指标比较(±s
1
Kubozono T, Miyata M, Kawasoe S, et al. High pulse wave velocity has a strong impact on early carotid atherosclerosis in a japanese general male population [J]. Circ J, 2017, 81(3): 310-315.
2
钟伟兵. 高血压患者同型半胱氨酸与颈动脉硬化的临床研究 [D]. 南昌: 南昌大学, 2014.
3
中国高血压防治指南修订委员会. 中国高血压防治指南2010 [J]. 中华高血压杂志, 2011, 19(8): 701-743.
4
王文, 张维忠, 孙宁玲, 等. 中国血压测量指南 [J]. 中华高血压杂志, 2011, 19(12): 1101-1115.
5
张园园, 王红宇. 动态血压监测在高血压管理中的应用 [J]. 中华高血压志, 2016, 24(12): 1187-1191.
6
Steinvil A, Sadeh B, Bornstein NM, et al. Impact of carotidatherosclerosis on the risk of adverse cardiac events in patients with and without coronary disease [J]. Stroke, 2014, 45(8): 2311-2317.
7
马杰, 徐新娟. 高血压与颈动脉粥样硬化的研究进展 [J]. 心血管病学进展, 2009, 30(1): 54-58.
8
Korhonen P, Kautiainen H, Aarnio P. Pulse pressure and subclinical peripheral artery disease [J]. J Hum Hypertens, 2014, 28(4): 242-245.
9
Shimabukuro M, Hasegawa Y, Higa M, et al. Subclinical carotid atherosclerosis burden in the Japanese: comparison between Okinawa and Nagano residents [J]. J Atheroscler Thromb, 2015, 22(8): 854-868.
10
Wu D, Li C, Chen Y, Xiong H, et al. Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes [J]. Medicine (Baltimore), 2016, 95(24): e3864.
11
Pan XF, Lai YX, Gu JQ, et al. Factors significantly associated with the increased prevalence of carotid atherosclerosis in a northeast chinese middle-aged and elderly population: a cross-sectional study [J]. Medicine (Baltimore), 2016, 95(14): e3253.
12
Allan PL, Mowbray PL, Lee AJ, et al. Relationship between carorid intima-media thickness and symptomatic and asymptomatic periphral arterial disease. The edinburgh artery study [J]. Stroke, 1997, 28(2): 348-353.
13
Talavera-Garcia E, Delgado-Lista J, Garcia-Rios A, et al. Influence of obesity and metabolic disease on carotid atherosclerosis in patients with coronary artery disease (cordio prev study) [J]. PLoS One, 2016, 11(4): e0153096.
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