新疆维吾尔族、汉族高血压患者颈动脉斑块与血压变异性的相关性

The correlation between carotid plaque and blood pressure variability in Uighurs and Han nationality hypertensive patients in Xinjiang

目的探讨新疆维吾尔族、汉族高血压患者颈动脉斑块与血压变异性(BPV)的关系。方法选取2010年2月至2013年4月就诊于新疆医科大学第一附属医院高血压科住院的原发性高血压患者1080例(汉族635例,维吾尔族445例)临床资料进行回顾性分析,对颈动脉斑块的相关危险因素进行多因素Logistic回归分析。结果同民族颈动脉斑块组与无斑块组在年龄、高血压病程、24h平均收缩压、24h平均舒张压、24h收缩压标准差、白天和夜间平均收缩压、白天和夜间平均舒张压、白天和夜间收缩压标准差、24h平均心率、总胆固醇、低密度脂蛋白胆固醇(LDL-C)等差异有统计学意义(均P<0.05)。多因素回归分析结果显示,总人群颈动脉斑块与年龄、吸烟、LDL-C、24h平均收缩压、夜间平均收缩压、24h收缩压标准差、夜间收缩压标准差呈正相关(OR分别为1.085、1.803、1.548、1.017、1.028、1.695、1.096,均P<0.05),汉族人群患颈动脉斑块的风险低于维吾尔族(OR=0.615,P<0.05)。汉族高血压患者颈动脉斑块与年龄、吸烟、LDL-C、24h平均收缩压、夜间平均收缩压、24h收缩压标准差、夜间收缩压标准差呈正相关(OR分别为1.081、2.157、1.565、1.026、1.026、1.600、1.082,均P<0.05),与24h平均心率呈负相关(OR=0.971,P<0.05)。维吾尔族高血压患者颈动脉斑块与年龄、夜间平均收缩压、24h收缩压标准差及夜间收缩压标准差呈正相关(OR分别为1.088、1.028、1.743、1.108,均P<0.05)。在总人群、汉族及维吾尔族人群中,24h收缩压标准差每增加5.55mm Hg,颈动脉斑块形成危险分别增加69.5%、60.0%和74.3%(均P<0.05)。结论新疆维吾尔族、汉族两民族高血压患者颈动脉斑块与24h收缩压标准差呈正相关,汉族人群颈动脉斑块风险低于维吾尔族人群。

Objective To investigate the relationship between carotid artery plaque and short-term blood pressure variability（BPV）in Uighurs and Han nationality hypertensive patients in Xinjiang. Methods A total of 1080（635Han nationality,445Uighur）cases of essential hypertensive patients in the first affiliated hospital of Xinjiang medical university between February 2010 and April 2013 were enrolled in our retrospective study,and the clinical data was collected. The related risk factors of carotid artery plaque were analyzed by multivariate Logistic regression analysis. Results In Han and Uighur hypertensive patients,the differences were statistically significant in age,duration of disease,24 haverage systolic blood pressure,24 haverage diastolic blood pressure,24 hsystolic standard deviation,daytime average systolic blood pressure,nighttime average systolic blood pressure,daytime average diastolic blood pressure,nighttime average diastolic blood pressure,daytime systolic standard deviation,nighttime systolic standard deviation,24 haverage heart rate,total cholesterol,low density lipoprotein-cholesterol（LDL-C）between hypertensives with and without carotid artery plaque（all P〈0.05）. Multivariate regression analysis results showed that in the total population,carotid artery plaque was associated positively with age,smoking,LDL-C,24 h mean systolic blood pressure,nighttime average systolic blood pressure,24 hsystolic standard deviation,and nighttime systolic standard deviation（OR =1.085,1.803,1.548,1.017,1.028,1.695,1.096,all P 〈0.05）.Compared with Uighur,the risk of carotid plaques was lower in Han（OR=0.615,P〈0.05）. In the Han nationality,carotid artery plaque was associated positively with age,smoking,LDL-C,24 hmean systolic blood pressure,nighttime average systolic blood pressure,24 hsystolic standard deviation,and nighttime systolic standard deviation（OR=1.081,2.157,1.565,1.026,1.026,1.600,1.082;all P〈0.05）,while was negatively related to 24 haverage heart rate（OR=0.971,P〈0.05）. In the Uighur population,carotid artery plaque was associated positively with age,nighttime average systolic blood pressure,24 hsystolic standard deviation and nighttime systolic standard deviation（OR=1.088,1.028,1.743,1.108,all P〈0.05）. The risk of carotid plaques increased 69.5%,60.0%and 74.3% respectively in the total,Han and Uighur population with 24 hsystolic standard deviation’increasing of5.55 mm Hg（all P〈0.05）. Conclusion In Xinjiang,hypertensive patients in Han and Uighur with carotid artery plaque is associated positively with 24 hsystolic standard deviation,the risk of carotid plaques is lower in Han than in Uighur.