动脉粥样硬化性心血管疾病与H型高血压的关系研究  

Relation between atherosclerotic cardiovascular disease and H-type hypertension

作　　者：张玉[1] 马亮亮[2] 张海垠[3] Zhang Yu;Ma Liangliang;Zhang Haiyin(The Second Department of Geratology,the First Hospital of Shijiazhuang,Shijiazhuang 050051,China;Department of Vascular Surgery,the First Hospital of Shijiazhuang,Shijiazhuang 050051,Chin;Department of Neurosurgery,First Hospital of Qinhuangdao,Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]石家庄市第一医院老年病二科,050051 [2]石家庄市第一医院血管外科,050051 [3]河北省秦皇岛市第一医院神经外科,066000

出　　处：《中国医药》2018年第11期1620-1623,共4页China Medicine

基　　金：河北省医学科学研究重点课题(20160802)~~

摘　　要：目的探讨动脉粥样硬化性心血管疾病(ASCVD)与H型高血压的关系。方法回顾性分析2015年3月至2017年8月于石家庄市第一医院就诊的260例ASCVD患者的病历资料,根据经皮冠状动脉造影检查结果分为观察组(血管狭窄率≥50%,192例)和对照组(血管狭窄率<50%,68例)。统计2组患者基线资料、血脂、血同型半胱氨酸(Hcy)水平及动态血压等检测结果。应用Logistic回归模型分析ASCVD与H型高血压及患者血Hcy水平的相关性。结果观察组年龄、H型高血压比例[93. 2%(179/192)比45.6%(31/68)]、非杓型或反杓型血压比例[65.6%(126/192)比17.6%(12/68)]、吸烟史比例、糖尿病史比例、三酰甘油水平、血Hcy水平[(24±12)μmol/L比(16±8)μmol/L大于/高于对照组(均P<0.05)。Logistic回归分析显示,年龄(比值比=1. 86,95%置信区间:1. 37～2.19,P=0.019 1)、H型高血压(比值比=6.18,95%置信区间:3.45～10. 87,P <0. 000 1)、非杓型或反杓型血压(比值比=5. 68,95%置信区间:4.15～11.08,P=0.001 4)、吸烟史(比值比=4.33,95%置信区间:2.08～9.02,P=0.012 5)、糖尿病史(比值比=2. 10,95%置信区间:1.49～3.04,P=0.021 8)、总胆固醇水平(比值比=3.15,95%置信区间:1. 88-6.04,P=0.009 7)均为ASCVD发生的危险因素;ASCVD发生风险与血Hcy水平呈明显正相关(r=3.041,P<0.05)。结论 H型高血压患者更易发生ASCVD。H型高血压患者出现非杓型或反杓型血压比例增大,血Hcy水平升高,均为促进ASCVD发生的重要因素,且血Hcy水平越高,发病风险越高。Objective To analyze the relation between atherosclerotic cardiovascular disease（ASCVD） and H-type hypertension. Methods Clinical data of 260 ASCVD patients who were treated in the First Hospital of Shijiazhuang from March 2015 to August 2017 were retrospectively analyzed. According to the results of percutaneous coronary angiography, the patients were divided into observation group（stenosis≥50%, n=192） and control group（stenosis〈50%, n=68）. Basic medical records, blood lipid, Hcy and ambulatory blood pressure were analyzed. The relation among ASCVD, H-type hypertension and Hcy level was analyzed by Logistic regression. Results Age, H-type hypertension ratio[93.2%（179/192） vs 45.6%（31/68）], non-dipper and anti-dipper blood pressure ratio[65.6%（126/192） vs 17.6%（12/68）], smoking history ratio, diabetes history ratio, triglyceride level, Hcy level[（24±12）μmol/L vs （16±8）μmol/L] in the observation group were significantly higher than those in the control group（P〈0.05）. Logistic regression showed that age（odds ratio=1.86, 95% confidence interval： 1.37-2.19, P=0.019 1）, H-type hypertension（odds ratio=6.18, 95% confidence interval： 3.45-10.87, P〈0.000 1）, non-dipper or anti-dipper blood pressure（odds ratio=5.68, 95% confidence interval：4.15-11.08,P=0.001 4）, smoking history（odds ratio=4.33, 95% confidence interval： 2.08-9.02, P=0.012 5）, diabetes history（odds ratio=2.10, 95% confidence interval： 1.49-3.04, P=0.021 8） and total cholesterol level（odds ratio=3.15, 95% confidence interval： 1.88-6.04, P=0.009 7） were risk factors of ASCVD. There was a positive correlation between ASCVD and Hcy level（r=3.041, P〈0.05）. Conclusion sPatients with H-type hypertension are more likely to develop ASCVD. Non-dipper or anti-dipper blood pressure and elevated blood Hcy level in H-type hypertension patients may increase the risk of ASCVD.

关 键 词：动脉粥样硬化性心血管疾病 H型高血压 同型半胱氨酸 

分 类 号：R54[医药卫生—心血管疾病]