合并颈动脉粥样硬化的老年高血压患者危险因素分析

Possible risk factors about carotid atherosclerosis in the elderly high blood pressure patients

目的探讨合并颈动脉粥样硬化(CAS)的老年高血压患者其危险因素情况。方法将2009年4月—2014年5月在我院进行高血压治疗的318例老年患者,测量颈动脉内膜-中膜厚度IMT),观察是否有斑块形成,分为颈动脉粥样硬化组和颈动脉非粥样硬化组,对两组患者的相关危险因素进行对比以及Logistic多因素分析。结果通过对两组患者治疗开始时的各项指标进行检测,发现除年龄、吸烟、肥胖外,两组患者在病程、24 h平均收缩压(SBP)、24 h平均舒张压(DBP)、脉压、血脂异常、糖尿病、葡萄糖调节受损(impaired glucose regulation,IGR)、高尿酸血症等差异均有统计学意义(P<0.05)。进一步的Logistic多因素回归分析表明血脂异常、SBP、脉压、糖尿病、IGR对颈动脉粥样硬化形成相关(OR分别为1.123、3.989、1.902、2.641、2.789、2.513,P<0.01)。结论血脂异常、SBP、脉压、糖尿病、IGR对于老年高血压患者颈动脉粥样硬化形成及恶化有显著的关系,在临床实践中,应重视对相关危险因素的控制。

Objective To investigate the possible risk factors about carotid atherosclerosis（ CAS） in the elderly patients with high blood pressure. Methods Carotid ultrasound was performed to measure intimamedia thickness,lumen diameter and plaques. 318 cases of elderly patients with high blood pressure collected from April 2009 to May 2014 in our hospital were divided into the CAS and non-CAS groups. The possible risk factors of carotid atherosclerosis were analyzed in two groups. Results The indexes,except age,smoking and obesity,about years of hypertention,24 h mean systolic blood pressure（ SBP）,24 h mean diastolic blood pressure（ DBP）,pulse pressure,dyslipidemia,diabetes,impaired glucose regulation（ IGR）and hyperuricemia were significantly different between two groups（ P 0. 05）. Logistic multivariate analysis showed that the factors including dyslipidemia,SBP,pulse pressure,diabetes and IGR were significantly correlated to CAS in the elderly high blood pressure patients（ OR were 1. 123,3. 989,1. 902,1. 123,2. 789 and 2. 513,P 0. 01）. Conclusion Factors such as dyslipidemia,SBP,pulse pressure,diabetes and IGR are significantly correlated to CAS in the elderly high blood pressure patients,which should be attach more attention in the clinical practice.