原发性高血压并发心脑血管疾病患者的危险因素分析

Analysis of risk factors of patients with essential hypertension complicating cardiovascular and/or cerebrovascular diseases

目的:研究原发性高血压(EH)伴冠心病和/或脑血管病患者的临床特点,分析其相关的危险因素。方法:对55例EH伴冠心病和/或脑血管病患者,进行动脉硬化指数(ASI)测定,并检测患者的血尿酸、血糖、血脂、肌酐、尿素氮等血液生化指标及一般情况。另选不伴有冠心病、脑血管病的高血压患者63例作为对照。结果:与单纯高血压对照组比较,EH伴冠心病和/或脑血管的年龄大、病史时间长,ASI、脉压、血尿素氮水平明显升高(均P<0.01);收缩压、血尿酸、总胆固醇、肌酐水平也升高(均P<0.05);而舒张压(P<0.01),心率(P<0.05)却较低。多因素logistic回归分析显示:EH并发心脑血管疾病的相关危险因素有脉压、血肌酐、年龄(OR=1.204,1.120,1.099,P=0.028,0.045,0.039);而血尿酸是负相关因素(OR=0.974,P=0.022)。结论:脉压、血肌酐水平和年龄可能是高血压患者并发心脑血管疾病的危险因素;血尿酸可能是一种保护因素。

Objective： To investigate the clinical characteristics of patients with essential hypertension （EH） complicating coronary heart diseases and/or cerebral vascular diseases and analyze risk factors about it. Methods： A total of 118 EH patients were recruited and divided into two groups., simple EH patient group （n=63） and group of EH patients complicating coronary hear diseases （CHD） and/or cerebral vascular diseases （n=55）. The demographic characteristics, arterial stiffness index （ASI） and blood biochemical parameters were measured and compared between the two groups. Results.. Comparing with simple EH patients, there were older age, longer hypertensive history, higher values of arterial stiffness index, pulse pressure, serum creatinine （all P〈0. 01）, higher values of systolic blood pressure, blood uric acid, total cholesterol, blood urea nitrogen （all P〈0. 05）, but lower values of diastolic blood pressure （P〈0. 01）, heart rate （P〈0. 05） in the group of EH patients complicating CHD and/or CVD. Logistic regression analysis showed that pulse pressure, serum creatinine and age （OR=1. 204, 1. 120, 1. 099, P=0. 028, 0. 045, 0. 039, respectively） were positive risk factors, but the blood uric acid was a negative factor （OR= 0. 974, P=0. 022） for the EH patients complicating CHD and/or CVD. may be independent risk factors and blood uric acid may be or CVD. Conclusion： The pulse pressure, serum creatinine and age a protective factor for EH patients complicating CHD and/ or CVD.