心肌梗死患者血清甘油三酯与平均动脉压的关系  

Relationship between serum triglyceride and mean arterial pressure in patients with myocardial infarction

作　　者：姚馨怡 乔香瑞 荐志洁[1] 吴岳[3] 成乐乐 YAO Xinyi;QIAO Xiangrui;JIAN Zhijie;WU Yue;CHENG Lele(Department of Medical Imaging,First Affiliated Hospital of Xi'an Jiaotong University,Xi’an 710000,China;Xi'an Jiaotong University Health Science Center;Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University)

机构地区：[1]西安交通大学第一附属医院医学影像科,西安710000 [2]西安交通大学医学部 [3]西安交通大学第一附属医院心血管内科

出　　处：《山西医科大学学报》2023年第7期939-943,共5页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(82200500);国家重点研发计划项目(2019YFA0802300)。

摘　　要：目的 探讨心肌梗死患者血清甘油三酯(TG)与平均动脉压(MAP)的相关关系。方法 纳入2019年1月至2020年12月在西安交通大学第一附属医院住院的心肌梗死患者,收集一般临床资料,根据血清TG水平的四分位数将受试者分为Q1,Q2,Q3,Q4四组,比较四组患者的MAP、年龄、性别、总胆固醇、低密度脂蛋白、糖化血红蛋白、空腹葡萄糖、白蛋白、血小板计数、白细胞、收缩压、舒张压等临床指标的差异。采用Spearman相关性分析及单因素和多因素线性回归方法分析血清TG水平与MAP的关系。结果 共纳入患者7 341例,Q1组1 824例,Q2组1 843例,Q3组1 829例,Q4组1 845例。从Q1组到Q4组,患者总胆固醇、低密度脂蛋白、糖化血红蛋白、空腹葡萄糖、白蛋白、血小板计数、白细胞、收缩压、舒张压、MAP水平均逐渐升高,且四组间差异有统计学意义(P<0.001),其中Q4组MAP的中位数比Q1组增加了5.34 mmHg;而年龄、高密度脂蛋白、B型前脑尿钠肽水平均逐渐降低,且四组间差异有统计学意义(P<0.001),其中Q4组年龄中位数比Q1组降低了6岁。经Spearman相关分析,心肌梗死患者的血清TG水平与MAP呈正相关(r=0.130,P<0.001)。单因素线性回归分析显示,血清TG水平每增加1 mmol/L,MAP增加1.67 mmHg(95%CI 1.38~1.97,P<0.001);与Q1组相比较,Q2组MAP增加2.07 mmHg(95%CI 1.13~3.02,P<0.001),Q3组MAP增加3.81 mmHg(95%CI 2.87~4.76,P<0.001),Q4组MAP增加5.58 mmHg(95%CI 4.64~6.53,P<0.001)。多因素线性回归分析显示,在校正年龄、性别及其他多种临床指标后,血清TG水平每增加1 mmol/L,MAP增加0.8 mmHg(β=0.80,95%CI 0.37~1.23,P<0.001);与Q1组相比较,Q3组MAP增加2.08 mmHg(95%CI 0.79~3.36,P=0.002),Q4组MAP增加2.58 mmHg(95%CI 1.20~3.95,P<0.001)。结论 心肌梗死患者血清TG水平与MAP呈正相关关系,MAP随血清TG水平的升高而增大。Objective To investigate the relationship between serum triglyceride(TG)and mean arterial pressure(MAP).Methods Patients with myocardial infarction who were hospitalized in the First Affiliated Hospital of Xi’an Jiaotong University from January 2019 to December 2020 were enrolled to collect the general clinical data.The subjects were divided into four groups based on the quartile of serum TG level:Q1 group,Q2 group,Q3 group,and Q4 group.MAP,total cholesterol,low-density lipoprotein,glycosylated hemoglobin,fasting blood glucose,albumin,platelet count,white blood cells,systolic blood pressure,and diastolic blood pressure were compared among the four groups.Spearman correlation analysis,univariate and multivariate linear regression analysis were employed to examine the correlation between serum TG level and mean arterial pressure(MAP).Results A total of 7341 patients were included in this study,including 1824 in Q1 group,1843 in Q2 group,1829 in Q3 group,and 1845 in Q4 group.Total cholesterol,low-density lipoprotein,glycosylated hemoglobin,fasting glucose,albumin,platelet count,white blood cell,systolic blood pressure,diastolic blood pressure,and MAP gradually increased from Q1 group to Q4 group,and the differences among the four groups were statistically significant(P<0.001).In comparison to Q1 group,MAP increased by 5.34 mmHg in Q4 group.Moreover,the levels of age,high density lipoprotein,and B-type pro-brain natriuretic peptide gradually decreased from Q1 group to Q4 group,and the differences among four groups were statistically significant(P<0.001).The median age in Q4 group decreased by six years compared to Q1 group.Spearman correlation analysis showed that there was a positive correlation between serum TG level of myocardial infarction patients and MAP(r=0.130,P<0.001).The univariate linear regression analysis also showed that MAP increased by 1.67 mmHg for every 1 mmol/L increase in serum TG level.Compared to Q1 group,MAP increased by 2.07 mmHg in Q2 group(95%CI 1.13-3.02,P<0.001),3.81 mmHg in Q3 group(95%

关 键 词：甘油三酯 平均动脉压 心肌梗死 心血管疾病 相关性分析 

分 类 号：R542.22[医药卫生—心血管疾病]