男性公安民警H型高血压与左室肥厚的关系  

Correlation of left ventricular hypertrophy with H type hypertension patients of male policemen

作　　者：裴璠[1] 杨虹[2] PEI Fan;YANG Hong(Department of Health Care,Tianjin Public Security Hospital,Tianjin,300042,China;Department of Physical Examination,Tianjin Public Security Hospital,Tianjin,300042,China)

机构地区：[1]天津市公安医院保健科,天津300042 [2]天津市公安医院物检科,天津300042

出　　处：《职业与健康》2020年第12期1611-1614,共4页Occupation and Health

基　　金：天津市公安局科技基金项目(2017KYSGAY019)。

摘　　要：目的探讨公安民警高同型半胱氨酸血症(HHcy)与高血压是否会协同作用导致左室肥厚(LVH),以期为临床早期干预提供参考依据。方法收集2017年11月—2019年1月在天津市公安医院进行健康检查的186例患高血压的男性公安民警,根据血清同型半胱氨酸(Hcy)水平分为H型高血压组(H组)101例和非H型高血压组(NH组)85例,检测Hcy、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)等生化指标;应用彩色多普勒超声测量左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)和左心室射血分数(LVEF),连续测量3个周期取平均值。根据Devereux校正公式计算左心室质量(LVM)和左心室质量指数(LVMI)。多因素logistic回归分析LVH的影响因素。结果 H组LVH发生率(16.83%)、IVST[(1.06±0.63)cm]、IVPWT[(1.15±0.11)cm]、LVEDD[(4.82±0.52)cm]、LVMI [(92.12±33.37)g/cm2]均高于非H组[7.05%、(0.97±0.14)cm、(0.91±0.14)cm、(4.54±0.48)cm、(77.55±24.15)g/cm2],差异均有统计学意义(均P<0.05)。Pearson相关分析显示,LVMI与Hcy、SBP、DBP、TG、FPG呈正相关,与HDL-C呈负相关(均P<0.05)。多因素logistic回归分析显示,Hcy升高(OR=1.045,95%CI:1.003~1.089)和SBP升高(OR=1.034,95%CI:1.010~1.059)均是LVH的独立危险因素(均P<0.05)。结论对患高血压的公安民警常规检测Hcy非常必要,在控制血压的同时降低Hcy水平,可有效减少LVH的发生。Objective To explore whether hyperhomocysteinemia(HHcy) and hypertension can cause left ventricular hypertro-phy(LVH) synergistically in policemen, provide reference for early clinical intervention. Methods 186 male policemen with hypertension,who received the health examination in Tianjin Public Security Hospital from November 2017 to January 2019,were divided into two groups according the serum homocysteine(Hcy) level,including H-type hypertension group(H group,n=101) and non-H-type hypertension group(NH group,n=85). The biochemical indexes of Hcy fasting plasma glucos(FPG),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C) were detected. Left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)and left ventricular ejection fraction(LVEF) were measured by color Doppler echocardiography, taking the average value of three consecutive measurement periods. Left ventricular mass(LVM) and left ventricular mass index(LVMI) were calculated with the Devereux correction formula. Multivariate logistic regression was used to explore the influencing factors of LVH.Results The incidence of LVH(16.83%),IVST[(1.06±0.63)cm],IVPWT [(1.15±0.11)cm],LVEDD[(4.82±0.52)cm] and L VMI[(92.12±33.37)g/cm2] in H group were higher than those in NH group[7.05%,(0.97±0.14)cm,(0.91±0.14)cm,(4.54±0.48)cm,(77.55±24.15)g/cm2],and the differences were statistically significant(all P<0.05). Pearson correlation analysis showed that LVMI was positively correlated with Hcy,SBP,DBP,TG and FPG,while negatively correlated with HDL-C(all P<0.05). Multivariate logistic regression showed that Hcy incrassation(OR=1.045,95%CI:1.003-1.089) and SBP incrassation(OR=1.034,95% CI:1.010-1.059)were the independent risk factor for LVH. Conclusion Routine detection of Hcy in policemen with hypertension is very necessary.It can effectively reduce the occurrence of LVH by reducing Hcy while controlling blood pr

关 键 词：高血压 同型半胱氨酸 左室肥厚 公安民警 危险因素 

分 类 号：R181.31[医药卫生—流行病学]