高血压合并冠心病的危险因素及相关性  

Risk factors of hypertension complicated with coronary heart disease

作　　者：张倩倩[1] 陶琳琳[1] 聂玉梅[1] 刘顺 周碧蓉[1] 

机构地区：[1]安徽医科大学第一附属医院心血管内科,合肥市230022 [2]安徽医科大学,合肥市230032

出　　处：《实用医学杂志》2017年第21期3566-3569,共4页The Journal of Practical Medicine

基　　金：安医大一附院后备人才基金资助;地方高校国家级大学生创新创业训练计划项目(编号:201510366014)

摘　　要：目的探讨高血压患者合并冠心病(CAD)的危险因素及相关性。方法纳入2015年8月至2016年12月安徽医科大学第一附属医院心内科收治的高血压病患者258例,根据冠状动脉造影结果分为高血压组(124例),高血压合并冠心病组(134例)。记录研究对象的一般资料、血小板参数、血脂水平、肾功能指标。比较两组患者各指标的差异,并分析这些指标与高血压患者并发冠心病的相关关系。结果(1)与高血压组患者相比,高血压合并冠心病组患者的年龄较大、吸烟者较多、血小板分布宽度、平均血小板体积(MPV)、肌酐、血尿酸的值较高,而HDL-C水平较低,差异均有统计学意义(P<0.05)。(2)多因素Logistic回归分析显示:年龄、吸烟史、MPV、血尿酸及低水平的HDL-C是高血压患者合并冠心病的独立危险因素[OR=1.062,95%CI:1.032~1.093;OR=2.048,95%CI:1.078~3.893;OR=2.737,95%CI:1.193~6.278;OR=1.006,95%CI:1.001~1.010;OR=0.280,95%CI:0.115~0.681(均P<0.05)]。(3)Pearson相关分析结果显示:MPV和血尿酸呈正相关(r=0.17,P<0.05)。结论年龄、吸烟史、MPV、血尿酸和较低的HDL-C值是高血压患者并发冠心病的危险因素,应当积极检测并预防,以降低高血压合并冠心病的发病风险。Objective To investigate the risk factors of hypertension patients combined with coronaryartery disease(CAD)and analyze the correlation. Methods A total of 258 hospitalized hypertension patientsfrom August 2015 to December 2016 were divided into hypertension group(n = 124)and hypertension combinedwith CAD group(n = 134),according to the results of coronary angiography. The general data,platelet parame-ters,blood lipid level and renal function indexes of all objects were recorded. The differences of all indexesbetween 2 groups were compared,and the correlation between these indexes and CAD in hypertensive patients wasanalyzed. Results(1)More smokers and older patients were found in hypertension combined with CAD group;the values of mean platelet volume(MPV),platelet distribution width,creatinine,serum uric acid were higher,but HDL-C level was lower and all the differences were statistically significant(P < 0.05).(2)Multivariablelogistic regression analysis demonstrated that age,smoking history,MPV,serum uric acid and low level of HDL-Cwere independent hazardous factors of CAD in hypertensive patients[OR = 1.062,95%CI:1.032 ~ 1.093;OR =2.048,95%CI:1.078 ~ 3.893;OR = 2.737,95%CI:1.193 ~ 6.278;OR = 1.006,95%CI:1.001 ~ 1.010;OR =0.280,95%CI:0.115 ~ 0.681(all,P < 0.05)].(3)Pearson correlation analysis showed that MPV was positivelycorrelated with serum uric acid(r = 0.17,P < 0.05). Conclusions Age,smoking history,MPV,serum uricacid and lower HDL-C value are risk factors of CAD in hypertensive patients and active detection and preventionwill benefit reducing the risk for the occurrence of CAD in hypertensive patients.

关 键 词：冠心病 高血压 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]