饮食习惯对高血压患者动脉粥样硬化的影响

Effects of diet habits on atherosclerosis in essential hypertensive patients

目的比较不同饮食习惯下血脂与血尿酸改变对原发性高血压患者动脉粥样硬化的影响。方法选取2016年1月～2017年6月无糖尿病的原发性高血压患者的291例,其中珠海市患者164例图木舒克市患者127例。检测两地患者血液中的尿酸(UA)、总胆固醇(TC)与甘油三酯(TG)水平,同时用颈动脉超声测定患者的颈动脉内膜-中层厚度(CIMT),作为评估动脉粥样硬化的方法。结果由于饮食习惯的差异,珠海患者并发高尿酸血症的比例较高,图木舒克患者并发高脂血症的比例较高(P<0.05)。尿酸与总胆固醇是两地高血压患者的动脉粥样硬化的共同危险因素(P<0.05)。在海珠地区尿酸(r=0.420)与患者CIMT相关性更高,而图木舒克地区总胆固醇与患者CIMT相关性更高(r=0.286)。结论珠海地区高尿酸血症与动脉粥样硬化关系更密切需减少膳食中嘌呤的摄入;图木舒克地区高脂血症与动脉粥样硬化关系更密切需减少膳食中油脂的摄入,将可更加具有针对性的有效的减缓高血压患者的动脉粥样硬化进程。

Objective To explore the effects of blood lipids and uric acid（UA） on carotid atherosclerosis（CAS） in essential hypertensive patients with different diet habits. Methods The clinical data of 291 patients with essential hypertension from January 2016 to June 2017 were collected, including 164 patients from Zhuhai and 127 patients from Tumxuk. The serum levels of UA, total cholesterol（TC） and total triglyceride（TG） were detected, and the carotid intima-media thickness（CIMT） were observed as a method to evaluate CAS. Results Due to different diet habits, patients from Zhuhai had a higher incidence of hyperuricemia, whereas patients from Tumxuk had a higher incidence of hyperlipemia（P〈0.05）. UA and TC were risk factors of CAS in the elderly patients with cerebral infarction（P〈0.05）from both districts. UA（r=0.420） and CIMT had a higher correlativity in patients from Zhuhai, while TC（r=0.286） and CIMT had a higher correlativity in patients from Tumxuk.Conclusion Since hyperuricemia was closely related with CAS for people from Zhuhai, the local people need to reduce the purine intake; while in Tumxuk hyperlipemia was closely related with CAS, so the local people need reduce dietary fat intake.In this way, essential hypertensive patients can be efficiently protected from CAS.