红细胞分布宽度和中性粒细胞淋巴细胞比值对非杓型血压的预测价值

Predictive value of red blood cell distribution width and neutrophil to lymphocytes ratio in the diagnosis of patients with non-dipping hypertension

目的探讨非杓型血压的临床特点和相关因素,以提高非杓型血压的知晓率。方法选择住院部原发性高血压或其他心脏疾病并发原发性高血压的患者105例,按昼夜血压波动情况分为杓型血压组及非杓型血压组。分别两组收集临床资料,并行血常规、血生化等辅助检查的结果。结果 105例患者中,杓型血压患者37例(35.2%),非杓型血压患者68例(64.8%)。且非杓型血压患者红细胞分布宽度(RDW)、血小板计数、中性粒细胞淋巴细胞比值(NLR)及血小板淋巴细胞比值(PLR)均较杓型血压患者显著升高(P<0.05)。Logistic回归分析和ROC曲线结果提示,当RDW≥14.1%及NLR≥1.9与非杓型血压的预测显著相关(P<0.01)。结论住院高血压病患者中非杓型血压的发生率较高,RDW≥14.1%及NLR≥1.9是非杓型高血压发生的独立预测因子。

Objective To investigate the clinical manifestations and relative factors of non-dipping hypertension in or- der to improve its diagnosis. Methods A total of 105 cases of patients with primary hypertension or other cardiovascu- lar diseases without severe complications were selected. All the patients were divided into two groups based on the di- urnal and nocturnal alternation of blood pressure, including the dipping hypertension group and non-dipping hyperten- sion course group. Clinical data, complete blood count and blood biochemical examination were analyzed and collected. Results Among the 105 cases of selected patients, dipping hypertension and non-dipping hypertension were detected in 37（35,2%） and 68 （64.8%）. Compared with non-dipping hypertension group, the red blood cell distribution width （RDW）, platelet count, neutrophil to lymphoeytes ratio（NLR） and platelet to lymphocyte ratio were significantly higher than dipping hypertension group （P〈0.05）. Logistic regression analysis and ROC curve indicated that RDW≥ 14.1% and NLR≥ 1.9 were strongly correlative with the prediction and prognosis of non-dipping hypertension （P〈0.01）. Conclusion Morbidity of non-dipping hypertension is relatively higher in hospitalized patients. RDW ≥114.1% and NLR≥ 1.9 can be regarded as independent predictors for non-dipping pattern in primary hypertension.