不同类型高血压红细胞参数的比较分析

The Comparative Analysis of RBC Parameters among Different Types of Hypertension

目的研究不同类型高血压人群的血常规变化。方法选择2012年7月—2015年7月在中国中医科学院广安门医院南区体检者1 807名,详细记录病史,测量身高、体重、体重指数(BMI)、血压等,检测血常规、生化、血液流变学等指标,应用Coulter LH780血细胞分析仪测定血常规指标,根据健康状态和血压值分为4组,健康组(n=1 164)、双期高血压组(n=282)、单纯舒张期高血压组(n=117)、单纯收缩期高血压组(n=244),将4组红细胞参数进行比较分析。结果经单因素方差分析检验,双期高血压组、单纯舒张期高血压组、单纯收缩期高血压组3组红细胞(RBC)、血红蛋白(HGB)、血细胞比容(HCT)均明显高于健康组,差异有统计学意义(P<0.05);双期高血压组、单纯舒张期高血压组平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)均明显高于健康组,差异有统计学意义(P<0.05);健康组、双期高血压组、单纯舒张期高血压组3组红细胞分布宽度变异系数(RDW-CV)、红细胞分布宽度标准差(RDW-SD)均明显低于单纯收缩期高血压组,差异有统计学意义(P<0.05)。双期高血压组、单纯舒张期高血压组平均红细胞血红蛋白浓度分别均明显高于健康组、单纯收缩期高血压组,差异有统计学意义(P<0.05);健康组、单纯收缩期高血压组红细胞血红蛋白浓度(MCHC)明显低于双期高血压组,差异有统计学意义(P<0.05)。多元逐步回归分析显示:RDW-CV(OR=3.470,P=0.000)、HGB(OR=0.328,P=0.000)是收缩压的独立危险因素;RDW-CV(OR=1.676,P=0.000)、HGB(OR=0.226,P=0.000)是舒张压的独立危险因素。结论 RDW-CV、HGB是血压的独立危险因素,单纯收缩期高血压病人,在降压同时,服用他汀类药物可更好地控制血压,并减少并发症的发生。

Objecllvo To study the changes of the routine blood test among different types of hypertension.Methods One thousandseight hundreds and seven patients were selected from July 2012 to July 2015 in the medical center of the Southern District of Guanganmen Hospital .China Academy of Chinese Medical Sciences.The medical history, height weightJBMI ,blood pressure .blood routinand biochemical indicators,blood rheology and other indicators were observed.The patients were divided into four groups based othe health state and blood pressure,namely health group （n = 1164）,hypertensive group （n = 282）,isolated diastolic hypertensiogroup （n = 117）,isolated systolic hypertension group （n = 244）.The red blood cell parameters were compared among four groupResults The levels of red blood cells （RBC）,hemoglobin （HGB） and hematocrit （HCT） in group B,group C and group D were highethan that in group A （ P 〈 0.05）.The levels of mean corpuscular volume （MCV） and mean corpuscular hemoglobin （MCH） in group Bgroup C were higher than that in group A （P 〈 0.05）.The red cell distribution width （RDW） coefficient of variation （RDW CV）,RDWstandard deviation （RDW SD） in group A,group B and group C were lower than that in group D （P 〈0.05）.Mean corpuscular hemoglobin concentration （MCHC） in group B,group C were higher than that in group A and group D （P 〈 0.05）.MCHC in group A angroup D were lower than that in group B （P 〈 0.05）.Multiple regression analysis showed that RDW CV （OR = 3.470, P = 0.000） anHGB （OR =0.328, P =0.000） were independent risk factors for systolic blood pressure.RDW CV （OR = 1.676, P = 0.000） and HG（OR = 0.226, P = 0.000） were independent risk factors for diastolic blood pressure.Conclusion RDW CVJHGB are the independent risk factor for blood pressure.Especially for patients with isolated systolic hypertension,statin drugs and antihypertensive drugcan control blood pressure and reduce the incidence of complications.