北京地区人群血浆纤维蛋白原水平与10年间血压变化的关系

Association between plasma fibrinogen concentration and ten-year change in blood pressure

目的探讨中国35-64岁人群血浆纤维蛋白原（FIB）水平与10年间血压变化的关系。方法采用前瞻性队列研究的方法，对1992年在北京建立的一组35～64岁队列人群共2683人的基线FIB水平和10年间血压变化情况进行分析。结果（1）1992年北京地区35～64岁人群的血浆FIB水平中位数为3、8g／L（3．2～4．3异／L），FIB异常率为33．4％；FIB水平女性高于男性（P〈0.01），各年龄组间差异无统计学意义（P〉0.05），高血压组高于非高血压组（P〈0．05）。（2）北京地区人群10年后收缩压比1992年的血压水平升高10．0mmHg，舒张压升高5．0mmHg；FIB水平与收缩压和舒张压变化值的偏相关系数分别为0、125（P〈0．01）和0.047（P〈0、05），FIB异常组的收缩压升高值高于FIB正常组（P〈0．01）。（3）49．6％的人10年后血压分级比1992年的血压分级升高；FIB异常组的血压分级升高率高于FIB正常组（55．3％，46．8％，P〈0．01）。（4）在基线无高血压的人群中，FIB异常者10年后血压分级升高的危险是FIB正常者的1．46倍；而在基线时已有高血压的人群中，FIB异常者10年后血压分级升高的危险是FIB正常者的2．08倍。结论FIB水平与血压变化有关，改善血液的高凝和高黏状态对于血压控制、尤其是高血压患者的血压控制具有一定的意义。

Objective To explore the association between plasma fibrinogen （FIB） concentration and ten-year change in blood pressure in Chinese population aged 35 - 64. Methods A prospective cohort comprising 2683 subjects was established in Beijing in 1992. Blood pressure （BP） and other traditional cardiovascular risk factors were assessed in 1992 and 2002 respectively, and plasma FIB concentration was measured in 1992. The association of plasma FIB with ten-year change in blood pressure was analyzed. Results （ 1 ） The median concentration of FIB among this population was 3. 8 g/L （3. 2 - 4. 3 g/L） , and the percentage of the people with abnormal FIB concentration （FIB 〉 4. 0 g/L） was 33.4% in 1992. The FIB concentration of the females was higher than that of the males （ P 〈 0. 01 ） and the FIB concentration of the hypertensive subjects was significantly higher than that of the non-hypertensive subjects （ P 〈 0. 05 ）, however, there was no significant difference in the abnormal FIB rate among different age groups. （2） Compared with the BP levels in 1992, the systolic BP and diastolic BP of this population increased by 10.0 mm Hg and 5.0 mm Hg respectively in 2002. The partial correlation coefficients of baseline FIB concentration with ten-year difference for systolic and diastolic BP were 0. 125 （ P 〈 0. 01 ） and 0. 047 （ P 〈 0.05） respectively, and the absolute value of 10-year increase of systolic pressure in the subjects with abnormal FIB was significantly higher than that in those with normal FIB （ P 〈 0. 01 ）. （ 3 ） The BP grade 2002 was higher than the baseline grade in 1992 in 49. 6% of the study population. The BP grade increase rate of the subjects with abnormal FIB was 55.3% , significantly higher than that of the subjects with normal FIB （46.8%, P 〈 O. 05 ）. （4） In the population without baseline hypertension the risk of BP grade increase within 10 years in those with abnormal FIB was 1.46 times the risk in those with normal FIB, the multivariable OR （95%CI） was 1.457 （1.201 - 1.768） for those with normal BP and 2.082 （1.422 - 3. 048） for those with hypertension. Conclusion Plasma FIB concentration is associated with the BP change. Improvement of high coagulation and high adhesion help control BP, especially in people with hypertension.