基于高密度脂蛋白、甘油三酯、总胆固醇水平评估老年原发性高血压患者预后情况

Assessment of prognosis in elderly patients with essential hypertension based on high density lipoprotein,triglycerides and total cholesterol levels

目的探讨高密度脂蛋白(HDL)、甘油三酯(TG)、总胆固醇(TC)水平变化与老年原发性高血压患者预后的关系。方法选取2011年5月-2012年4月本院收治老年原发性高血压患者220例,随访3年,依据HDL、TG、TC水平分组,比较随访前后HDL、TG、TC水平变化,颈动脉厚度(IMT)、心电图,多因素Logistic回归分析HDL、TG/TC与预后关系。结果 3年后2组HDL水平均显著低于3年前,差异有统计学意义(P<0.05)。3年后HDL减低组HDL、SDNN水平低于HDL正常组,IMT高于HDL正常组,差异均有统计学意义(P<0.05)。3年后HDL减低组SDNN低于3年前,而IMT高于3年前,差异均有统计学意义(P<0.05)。多因素回归分析发现,血清HDL低水平、TG/TC高水平为原发性高血压患者心血管疾病预后危险因素。结论 HDL低水平、TG/TC高水平为原发性高血压患者心血管疾病危险因素。

Objective To explore the relationship between high density lipoprotein（ HDL）,triglycerides（ TG）,total cholesterol（ TC） levels changes and the prognosis in elderly patients with primary hypertension. Methods 220 cases of elderly patients with essential hypertension were selected from May 2011 to April 2012 in our hospital. Patients were followed up for 3 years.They were divided into different groups according to the HDL,TG,TC levels. HDL,TG,TC levels,carotid artery thickness（ IMT）,electrocardiogram were compared before and after the following- up; the correlation of HDL,TG/TC with hypertension prognosis was analyzed by Logistic regression. Results Three years later,HDL level in the two groups were significantly lower than that of three years ago,and the difference was statistically significant（ P〈0. 05）. After three years,the HDL,SDNN in lower HDL group was lower than that in normal group,IMT was higher than the normal group,and the differences were statistically significant（ P〈0. 05）. After 3 years,SDNN in lower HDL group reduced,while IMT was higher than that three years ago,and the differences were statistically significant（ P〈0. 05）. Multivariate linear regression analysis showed that low level of HDL and TG / TC high level were risk factors of cardiovascular disease prognosis in patients with primary hypertension. Conclusion Low serum HDL,TG / TC high levels are risk factors of essential hypertension in patients with cardiovascular disease.