高血压急症的影响因素研究

Influencing Factors of Hypertensive Emergencies

目的探讨高血压急症的影响因素。方法选取2015年9月—2017年7月在黑龙江省大庆市油田总医院心内科入院治疗的高血压患者782例,根据是否发生高血压急症分为非高血压急症组(n=472)和高血压急症组(n=310)。采用问卷调查的方式,收集纳入患者的临床资料,问卷内容包括一般情况调查表、Morisky服药依从性问卷、健康促进生活方式量表(HPLP-Ⅱ)、健康相关生命质量调查量表(SF-12)、社会支持评定量表(SSRS)、家庭功能评定量表(FAD)、健康行为自我效能量表(SRAHP)。比较两组患者的临床资料,采用多因素Logistic逐步回归分析探讨高血压急症的影响因素。结果高血压急症的发生率为39.6%。两组患者的性别、饮酒史、高血压家族史、脑血管病家族史、糖尿病家族史、BMI、腰围、SSRS得分比较,差异无统计学意义(P>0.05);吸烟史、糖尿病病史、心血管病家族史、食盐情况、运动情况、睡眠情况、服药依从性情况、年龄、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、HPLP-Ⅱ得分、SF-12得分、FAD得分、SRAHP得分比较,差异有统计学意义(P<0.05)。多因素Logistic逐步回归分析结果显示,糖尿病病史、睡眠情况、HPLP-Ⅱ得分、SF-12得分、FAD得分是高血压急症的影响因素(P<0.05)。结论高血压患者急症发生率较高,有糖尿病病史、睡眠较差、生活方式不良、生活质量不佳、家庭功能较差是其危险因素。

ObjectiveTo explore the influencing factors of hypertensive emergencies（HE）.MethodsA case-control study was performed among 782 patients with hypertension from Department of Cardiology,Daqing Oilfield General Hospital,Heilongjiang Province from September 2015 to July 2017.Of them,310 with a history of HE and other 472 without were assigned to HE group and non-HE group,respectively.Clinical data were collected by a questionnaire survey using a self-developed Baseline Characteristics Questionnaire,Chinese version of Morisky Medication Adherence Scale,Chinese version of Health-promoting Lifestyle Profile Ⅱ（HPLP-Ⅱ-C）,Chinese version of 12-item Short Form Health Survey（SF-12-C）,Social Support Rating Scale（SSRS）,Chinese version of Family Assessment Device（FAD-C）,and Chinese version of Self-rated Abilities for Health Practices Scale（SRAHP-C）,and were compared between the groups.Multivariate stepwise Logistic regression analysis was used to explore the influencing factors of HE.ResultsThe incidence of HE was 39.6%.There were no significant difference in sex,alcohol consumption history,family history of hypertension,family history of cerebrovascular disease,family history of diabetes,BMI,waistline and mean score of SSRS between the two groups（P〉0.05）.However,smoking history,diabetes history,family history of cardiovascular disease,salt consumption status,exercise status,sleep quality,medication compliance,age,fasting plasma glucose,total cholesterol,triglyceride,mean score of HPLP-Ⅱ-C,SF-12-C,FAD-C and SRAHP-C differed significantly between the groups（P〈0.05）.Multivariate stepwise Logistic regression analysis revealed that diabetes history,sleep quality,mean score of HPLP-Ⅱ-C,SF-12-C and FAD-C were the influencing factors of HE（P〈0.05）.ConclusionThe morbidity of HE is high in patients with hypertension.And diabetes history,poor sleep quality,poor lifestyle,poor quality of life and poor family functioning are the risk factors.