新疆乌鲁木齐地区维吾尔族与汉族难治性高血压相关危险因素

Risk factors for resistant hypertension in the Uygur and Hans in the areas of Wulumuqi Xinjiang

目的探讨维吾尔族与汉族(维汉)难治性高血压(RH)相关危险因素的异同。方法收集2003-05-2010-02住院的原发性高血压患者1367例,其中RH673例,非RH694例,汉族967例,维吾尔族400例。对维汉两民族患者的性别、年龄、高血压病程、吸烟史、高血压家族史、肥胖、血脂异常、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、糖尿病、糖耐量异常(IGT)及慢性肾脏病(CKD)等相关危险因素,分别进行单因素及多因素logistic回归分析。结果汉族RH组与非RH组相比,IGT比例较低(P<0.05),年龄较大、高血压病程较长、总胆固醇水平较高(均P<0.05),糖尿病患病率高、CKD比例高、治疗不当比例高及血脂异常的比例高(均P<0.05);维吾尔族RH组与非RH组相比,高血压家族史及IGT的比例较低(均P<0.05),年龄较大、高血压病程较长(均P<0.05),糖尿病患病率高、CKD比例高及治疗不当的比例高(均P<0.05)。经logistic回归分析结果显示:糖尿病(OR=13.840,P<0.01)、CKD(OR=9.369,P<0.01)及高血压病程(OR=1.063,P<0.01)与汉族RH独立相关;糖尿病(OR=11.135,P<0.01)、CKD(OR=8.959,P<0.01)及高血压病程(OR=1.052,P=0.012)与维吾尔族RH独立相关。结论高血压病程、糖尿病及CKD是维汉共同的独立危险因素。

Objective To investigate the similarities and differences of the risk factors for resistant hypertension（RH）in the Uygur and hans.Methods One thousand and three hundred and sixty seven essential hypertensive inpatients were enrolled between May.2003 and Feb.2010.Among patients,673 RH,694 non-RH;967 Hans and 400 Uygur.The clinical data of patients were collected,including gender,age,course of disease,smoking history,family histories of hypertension,obesity,blood lipid abnormality,total cholesterol,high-density lipoprotein-cholesterol（HDL-C）,low density lipoprotein-cholesterol（LDL-C）,triglyceride,diabetes mellitus,impaired glucose tolerance（IGT）,chronic kidney diseases（CKD）.The univariate and multivariate logistic regressions were performed to analyze the risk factors of the Uygur and hans RH.Results Compared with non-RH group,hans patients with RH group presented lower prevalence of IGT（P 0.05）,higher prevalence in elder patients,longer course of disease,higher total cholesterol herd,prevalence of diabetes,CKD,improper treatments and blood lipid abnormality（all P 0.05）;Compared with non-RH group,Uygur patients with RH group presented lower prevalence of family history of hypertension and IGT（all P 0.05）,higher prevalence in elder patients,longer course of disease,prevalence of diabetes,CKD and improper treatment（all P 0.05）.Logistic regression analysis showed that hans RH was associated with diabetes mellitus（OR =13.840,P 0.01）,CKD（OR =9.369,P 0.01）and course of disease（OR =1.063,P 0.01）;Uygur RH was also associated with diabetes mellitus（OR =11.135,P 0.01）,CKD（OR = 8.959,P 0.01）and course of disease（OR =1.052,P =0.012）.Conclusion CKD,diabetes mellitus,course of disease were independent risk factors for both the Uygur and Hans RH.