原发性高血压病患者1,25二羟维生素D水平与颈动脉内膜中层厚度及中心动脉压的相关性研究  

Correlation of 1,25-dihydroxy Vitamin D Level with Carotid Intima-media Thickness and Central Aortic Pressure in Patients with Essential Hypertension

作　　者：奴热姑.阿布都卡得 徐新娟[1] 张俊仕[1] 刘海明[1] 梁晓慧[1] NUREGU旳budukade;XU Xin-juan;ZHANG Jun-shi;LIU Hai-ming;LIANG Xiao-hui(Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心高血压科,新疆乌鲁木齐市830011

出　　处：《中国全科医学》2018年第8期914-918,共5页Chinese General Practice

基　　金：国家自然科学基金资助项目(30860296)

摘　　要：目的探讨新疆汉族和维吾尔族原发性高血压病患者1,25二羟维生素D水平与颈动脉内膜中层厚度(IMT)及中心动脉压(CAP)的相关性。方法选取2012—2016年于新疆医科大学第一附属医院高血压科诊断为原发性高血压病患者400例,根据血清1,25二羟维生素D水平将其分为汉族缺乏组154例、汉族非缺乏组93例、维吾尔族缺乏组92例、维吾尔族非缺乏组61例。检测患者总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、IMT及CAP指标包括中心动脉收缩压(CSP)、中心动脉舒张压(CDP)、中心动脉脉压(CPP)、增强压(AP)、反射波增强指数(AIx)。结果汉族缺乏组IMT大于汉族非缺乏组(P<0.05)。维吾尔族缺乏组HDL-C低于维吾尔族非缺乏组,IMT大于维吾尔族非缺乏组(P<0.05)。维吾尔族缺乏组CSP、CPP均高于维吾尔族非缺乏组(P<0.05)。相关性分析结果显示,汉族原发性高血压病患者1,25二羟维生素D水平与IMT呈负相关(r=-0.534,P<0.001);维吾尔族原发性高血压病患者1,25二羟维生素D水平与IMT、CSP、CPP呈负相关(r=-0.432、-0.171、-0.290,P<0.05)。多元线性回归分析结果显示,性别(t=-3.160)、年龄(t=3.274)、1,25二羟维生素D(t=-9.633)是汉族原发性高血压病患者IMT的影响因素(P<0.05);年龄(t=2.519)、1,25二羟维生素D(t=-5.990)是维吾尔族原发性高血压病患者IMT的影响因素(P<0.05)。结论 1,25二羟维生素D是汉族、维吾尔族原发性高血压病患者颈动脉IMT增加的独立危险因素之一。1,25二羟维生素D水平降低为维吾尔族原发性高血压病患者CSP、CPP增加的危险因素,可能与汉族原发性高血压病患者CAP无明显关系。Objective To investigate the correlation between 1,25-dihydroxy vitamin D level and carotid intimamedia thickness(IMT)and central aortic pressure(CAP)in Xinjiang Han and Uygur patients with essential hypertension.Methods We selected 400 patients hospitalized in Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University and diagnosed with essential hypertension from 2012 to 2016.According to the serum 1,25-dihydroxy vitamin D level,Han patients were divided into Han deficiency group(n=154)and Han sufficiency group(n=93),and Uygur patients were divided into Uygur deficiency group(n=92)and Uygur sufficiency group(n=61).Total cholesterol,triglyceride,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),IMT,and CAP indexes including central arterial systolic pressure(CSP),central arterial diastolic blood pressure(CDP),central arterial pulse pressure(CPP),augmented pressure(AP)and augmentation index(AIx)were measured in all patients.Results IMT was significantly higher in Han deficiency group than in Han sufficiency group(P<0.05).The level of HDL-C was significantly lower and carotid IMT was significantly higher in Uygur deficiency group than in Uygur sufficiency group(P<0.05).CSP and CPP were significantly higher in Uygur deficiency group than in Uygur sufficiency group(P<0.05).Pearson correlation analysis showed that 1,25-dihydroxy vitamin D was negatively associated with carotid IMT in Han patients(r=-0.534,P<0.001),and was negatively associated with IMT,CSP and CPP in Uygur patients(r=-0.432,r=-0.171,r=-0.290,P<0.05).Multivariate regression analysis showed that gender(t=-3.160),age(t=3.274)and 1,25-dihydroxy vitamin D level(t=-9.633)were the influencing factors of IMT in Han patients(P<0.05).Age(t=2.519)and 1,25-dihydroxy vitamin D(t=-5.990)level were the influencing factors of IMT in Uygur patients(P<0.05).Conclusion Serum 1,25-dihydroxy vitamin D level was an independent risk factor of increased carotid IMT in Han and Uygur patients.The deficiency in

关 键 词：高血压 维生素D 中心动脉压 颈动脉内膜中膜厚度 

分 类 号：R544.1[医药卫生—心血管疾病]