H型高血压合并射血保留心衰患者颈动脉斑块的检出情况分析

The detection condition of carotid artery plaques in patients with H type hypertension complicated by ejection reservation heart failure

目的研究H型高血压合并射血保留心衰患者颈动脉斑块的检出情况。方法选取2015年1月至2019年1月H型高血压合并射血保留心衰患者200例作为观察对象。将所有患者依据中国高血压防治指南(2010及2018年版)中高血压诊断标准及分级标准分成高血压1级38例、高血压2级61例、高血压3级101例;根据纽约心脏病学会(NYHA)心功能分级标准将所有患者分成心功能Ⅱ级组66例,Ⅲ级组64例,Ⅳ级组70例。分别对所有患者进行超声诊断仪检查颈动脉斑块形成情况,并比较不同H型高血压以及心功能分级患者的基本资料以及颈动脉斑块检出率情况,对指标间的关系予以相关性分析。结果高血压分级不同患者年龄、吸烟率、血糖异常率、血脂异常率比较差异均无统计学意义(P>0.05);高血压1级组、高血压2级组、高血压3级组患者的颈动脉斑块检出率分别为21.05%、40.98%、57.43%,其中高血压2级组、高血压3级组高于高血压1级组,且高血压3级组高于高血压2级组(P<0.05)。心功能分级不同患者年龄、吸烟率、血糖异常率、血脂异常率比较差异均无统计学意义(P>0.05);心功能分级为Ⅲ级、Ⅳ级患者的颈动脉斑块检出率分别为42.19%、71.43%,高于Ⅱ级组,且Ⅳ级组高于Ⅲ级组(P<0.05)。经Pearson相关性分析可得,H型高血压合并射血保留心衰患者颈动脉斑块检出率与高血压分级、心功能分级均呈正相关关系(均P<0.05)。结论H型高血压合并射血保留心衰患者颈动脉斑块检出情况与高血压分级、心功能分级可能存在密切相关,即随着患者病情的不断加重,颈动脉斑块检出率可能随之升高,值得临床重点关注。

Objective To investigate the detection status of carotid artery plaque in patients with H type hypertension complicated by ejection reservation heart failure.Methods A total of 200 patients with H type hypertension complicated by ejection reservation heart failure who were treated in our hospital from January 2015 to January 2019 were enrolled as observation objects,who were divided into grade 1 hypertension group(n=38),grade 2 hypertension group(n=61),and grade 3 hypertension group(n=101)according to the criteria of diagnostic and grading in the Chinese guidelines for hypertension prevention and treatment(2010 and 2018 edition).Moreover all the patients were divided into heart function classⅡgroup(n=66),heart function classⅢgroup(n=64)and heart function classⅣgroup(n=70)according to the grading standard of New York heart association(NYHA).All the patients were examined for carotid artery plaque formation by diasonograph,and the basic data of patients with different H type hypertension and heart function grades and the detection rate of carotid artery plaque were observed and compared.Moreover the correlation analysis between indexes was performed.Results There were no significant differences in patient’s age,smoking rate,abnormal blood glucose rate and dyslipidemia rate in patients with different grades of hypertension(P>0.05).Moreover the detection rates of carotid artery plaques in grade 1 hypertension group,grade 2 hypertension group and grade 3 hypertension group were 21.05%,40.98%and 57.43%,respectively.In addition the detection rates in grade 2 hypertension group and grade 3 hypertension group were significantly higher than those in grade 1 hypertension group,and the detection rate in grade 3 hypertension group was significantly higher than that in grade 2 hypertension group(P<0.05).However there were no significant differences in patient’s age,smoking rate,pathoglycemia rate and dyslipidemia rate in patients with different heart function grades(P>0.05).The detection rate of carotid artery plaque inⅢgrade heart function group and inⅣgrade heart function group was significantly higher than that inⅡgrade heart function group,moreover the detection rate of carotid artery plaque inⅣgrade heart function group was significantly higher than that inⅢgrade heart function group(P<0.05).Pearson correlation analysis showed that the detection rate of carotid artery plaque in patients with H type hypertension complicated by ejection reservation heart failure was positively correlated with the grading of hypertension and cardiac function(P<0.05).Conclusion The detection state of carotid artery plaques in patients with H type hypertension complicated by ejection reservation heart failure is closely related to the grading of hypertension and cardiac function, that is,the detection rate of carotid artery plaques may increase with the continuous aggravation of patients’ illness state, which is worthy of clinical attention.