老年高血压患者白细胞计数与血压控制水平相关性研究  

Study on relationship between white blood cell count and blood pressure control in elderly patients with hypertension

作　　者：王坤伟 刘军[1] 徐炯[1] 丁和远[1] 盛励[1] 查兵兵[1] 吴跃跃[1] 黄新梅[1] 王芳[1] 陈灶萍[1] 孙田歌[1] 韩晓洁[2] 顾勇[2] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,200240 [2]复旦大学附属上海市第五人民医院闵行区慢性病平台,200240

出　　处：《中华老年医学杂志》2015年第1期8-13,共6页Chinese Journal of Geriatrics

基　　金：上海市科学技术委员会科研计划项目（08411962500）

摘　　要：目的 探讨老年高血压患者中白细胞计数与其血压控制水平的相关性. 方法 入选上海市闵行区江川社区的1919例60岁以上服用≥1种降压药物的高血压患者为研究对象.测量身高、体质量、腰围、臀围、血压,检测外周血白细胞计数、血脂、空腹血糖、血肌酐.根据血压控制水平将其分为4组：血压＜120/80 mmHg（1 mmHg=0.133 kPa）组218例、120-139/80-89 mmHg组632例、140-159/90-99mmHg组754例、≥160/100mmHg组315例. 结果 随着血压水平升高,白细胞水平逐渐升高（P＜0.05）.Pearson相关分析结果显示,在男性高血压患者中,白细胞计数与收缩压、脉压、体质指数、体质量、腰围、腰臀比、三酰甘油和空腹血糖呈正相关性（r值分别为0.13、0.12、0.14、0.13、0.13、0.15、0.12和0.17,均P＜0.01）.Logistic多元回归分析结果显示,在校正年龄和心血管疾病危险因素后,血压≥160/100 mmHg组白细胞计数（＞7.1×10^9/L）升高是＜120/80mmHg组的1.518倍（95％CI：1.003-2.298,P＜0.05）;白细胞计数是收缩压及脉压的独立危险因素（均P＜0.01）.以血压140/90 mmHg为分界值,白细胞与血压的受试者工作特征曲线所得白细胞的切点值为5.25×10^9/L. 结论 老年高血压患者血压控制水平越差,其白细胞计数越高.白细胞计数可能是血压控制水平的预测指标之一.Objective To investigate the relationship between white blood cell count （WBC） and blood pressure control in elderly patients with hypertension.Methods A cross-sectional study was conducted in 1919 patients with hypertension aged 60 years or over who took one or more antihypertensive drugs from Jiangchuan Community of Shanghai.Height,weight,waist circumference,hip circumference,blood pressure,blood white blood cell count,blood lipid,fasting blood glucose and serum creatinine were measured.Subjects were classified into four groups：BP ≥120/80 mmHg（n=218） ;120-139/80-89 mmHg（n=632） ; 140-159/90-99 mmHg（n=754） ;≥160/100 mmHg （n=315）.Results White blood cell count was increased with the gradually increasing blood pressure （P〈0.05）.Pearson correlation analysis showed that WBC was positively related to systolic blood pressure,pulse pressure,body mass index,weight,waist,waist hip ratio,triglyceride and fasting blood glucose levels in male subjects （r=0.13,0.12,0.14,0.13,0.13,0.15,0.12 and 0.17,all P〈0.01）.Logistic regression analysis showed that the increase of WBC count was 1.518 folds higher in highest blood pressure group （≥160/100 mmHg） than in lowest blood pressure group （120/80 mmHg） （95%CI：1.003-2.298,P〈0.05） after adjusting for age and cardiovascular disease risk factors.Multiple regression analysis showed that WBC count was the independent factor for systolic blood pressure and pulse pressure （β =0.060 and 0.059,both P〈 0.01）.While BP 140/90mmHg as the boundary,the receiver operating characteristic curve （ROC） was used to evaluate the value of WBC count for blood pressure control.The optimal cut-off value of WBC was 5.25 10^9/L.Conclusions For the elderly patients with hypertension,the white blood cell count is increased with the poor blood pressure control.White blood cell count may be used as one of predictors for blood pressure control.

关 键 词：白细胞计数 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]