老年高血压病患者颈动脉内膜中层厚度增加的危险因素分析

Analysis of risk factors of carotid arterial intima-media thickness of elderly patients with essential hypertension

目的探讨老年高血压病患者颈动脉内膜中层厚度(IMTc)增加的危险因素。方法88例老年高血压病患者分2组,颈动脉内膜中层厚度(IMTc)≥0.9mm为增厚组(45例),<0.9mm为单纯组(43例),另设健康老年人对照组(30例)。3组均测身高、体重、收缩压(SBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、尿酸(UA)、空腹血糖(FBG)、空腹胰岛素(FIns),计算体重指数(BMI)、胰岛素抵抗指数(IR)。结果(1)SBP、FBG、INS、IR、TC、TG、LDL、HDL、UA、IMTc三组间差异有统计学意义。(2)直线相关分析示高血压患者IMTc与BMI、SBP、FBG、INS、IR、TC、TG、LDL、UA水平呈正相关,与HDL呈负相关。(3)多元逐步回归分析示IMTc与UA、INS、BMI、IR、TC、TG、LDL、HDL密切相关。结论高尿酸血症、胰岛素抵抗、肥胖、血脂代谢异常是老年高血压病患者颈动脉内膜中层厚度增加的危险因素。

Objective To explore risk factors of carotid arterial intima-media thickness（IMTc） of elderly patients with essential hyperten- sion. Methods 88 patients with essential hypertension were divided into two groups randomly： IMTc ≥ 0.9mm group （45 cases） and IMTc 〈 0.9 mm group （43 cases）, with thirty healthy cases as control. Body weight index（ B MI ）, systolic blood pressure （SBP） serum cholesterol （TC）, triglyeride（TG） ,low-density lipopretein （LDL）, high-density lipoprotein （HDL）, uric acid （UA）, blood fasting glucose （FBG）, fasting insulin （Fins） were） and insulin resistance were measured in three groups. Results （ 1 ） SBP, FBG, Fins, IR,TC,TG, LDL, HDL, UA, IMTc were significantly different in three groups. （2） There was positive correlation between IMTc and BMI, SBP,FBG, INS,IR,TC ,TG, LDL, UA by correlation analysis in hypertensive patients. There was negative correlation between IMTc and HDL. （3）There was correlation between IMTc and UA, INS, BMI,IR ,TC,TG, LDL, HDL by gradual regressive analysis in hypertensive patients. Conclusion Hyperuricacidemia, IR,obesity and hyperlipoidemia seem to be risk factors of IMTc in the elderly patients with essential hypertension.