H型高血压合并射血分数保留心力衰竭患者发生颈动脉硬化的危险因素分析

Risk factors of carotid atherosclerosis in patients with H-type hypertension complicated by heart failure with preserved ejection fraction

目的研究H型高血压合并射血分数保留心力衰竭(心衰)患者发生颈动脉硬化的危险因素。方法选取2015年1月至2019年1月于秦皇岛市第一医院心内科门诊就诊以及住院治疗的H型高血压合并射血分数保留心衰患者200例作为观察对象。将所有患者按照是否发生颈动脉硬化分为硬化组(89例)与非硬化组(111例)。分别比较两组基本资料,各项生化指标水平,并做多因素Logistic回归分析。结果硬化组年龄≥60岁、病程≥5年、吸烟、血糖控制效果差、睡眠呼吸暂停综合征人数占比相比非硬化组较高(均P<0.05)。硬化组与非硬化组在总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平方面对比,前者更高,而硬化组与非硬化组在高密度脂蛋白胆固醇(HDL-C)水平方面对比,前者更低(P均<0.05)。经多因素Logistic回归分析可得:年龄、病程、吸烟、血糖控制效果差、睡眠呼吸暂停综合征、TG、TC、LDL-C均是H型高血压合并射血分数保留心衰患者发生颈动脉硬化的独立危险因素,而HDL-C为保护性因素(P均<0.05)。结论随着年龄、病程的不断延长,血糖控制效果差、睡眠呼吸暂停综合征,TG、TC、LDL-C水平逐渐升高,HDL-C水平的逐渐降低,均可能会增加H型高血压合并射血分数保留心衰患者发生颈动脉硬化的风险。临床工作中应针对上述因素予以相关干预,继而达到降低颈动脉硬化发生风险的目的。

Objective To study the risk factors of carotid atherosclerosis(CAS)in patients with H-type hypertension complicated by heart failure with preserved ejection fraction(HFpEF).Methods The patients(n=200)were chosen as observation objects from Department of Cardiovascular Medicine in the First Hospital of Qinhuangdao City from Jan.2015 to Jan.2019.All patients were divided,according to whether or not they had CAS,into CAS group(n=89)and non-CAS group(n=111).The basic data and biochemical indexes were compared and multi-factor Logistic regression analysis was conducted in 2 groups.Results The percentages of patients aged≥60,and with disease course≥5 y,smoking history,poor blood sugar controlling and sleep apnea syndrome(SAS)were higher in CAS group than those in non-CAS group(all P<0.05).The levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein-cholesterol(LDL-C)were higher,and level of high-density lipoprotein-cholesterol(HDL-C)was lower in CAS group than those in non-CAS group(all P<0.05).The results of multi-factor Logistic regression analysis showed that age,disease course,smoking,poor blood sugar controlling,SAS,TG,TC and LDL-C were independent risk factors of CAS,and HDL-C was a protective factor of CAS in patients with H-type hypertension complicated by HFpEF(all P<0.05).Conclusion The increases of age and disease course,poor blood sugar controlling,SAS,gradually increases of TG,TC and LDL-C and gradually decrease of HDL-C all can promote the risk of CAS in patients with H-type hypertension complicated by HFpEF.