老年高血压合并心力衰竭的相关影响因素分析

Analysis of related factors of heart failure in the elderly patients with hypertension

目的观察老年高血压合并心力衰竭病人的临床特点,分析高血压病人并发心力衰竭的危险因素。方法收集2015年12月至2018年12月于渭南市中心医院就诊的138例高血压病人的临床资料,其中70例未合并心力衰竭的病人作为高血压组,68例合并心力衰竭的病人作为心力衰竭组。比较2组病人的左心室舒张末内径、心室间隔、SBP及DBP;检测并比较2组病人血清中BNP、CRP、肌酸激酶同工酶(CK-MB)、血管紧张素Ⅱ(AngⅡ)、皮质醇(Cor)、内皮素-1(ET-1)的水平;采用多因素Logistic回归分析老年高血压并发心力衰竭的相关影响因素。结果心力衰竭组左心室舒张末内径、室间隔、SBP、DBP均大于高血压组,差异有统计学意义(P <0. 05)。心力衰竭组的BNP、CRP、CK-MB、AngⅡ、Cor、ET-1水平均高于高血压组,差异有统计学意义(P <0. 05)。多因素Logistic回归分析结果显示,年龄≥70岁、FPG≥7. 0 mmol/L、合并高脂血症、左室肥厚、血压控制不达标是老年高血压病人并发心力衰竭的独立危险因素(P <0. 05)。结论老年高血压病人需严格控制血压,同时密切关注机体血糖、血脂的变化,早期预防心力衰竭的发生。

Objective To observe the clinical characteristics of the elderly patients with hypertension and heart failure,and to analyze the risk factors of heart failure in the hypertensive patients.Methods The clinical data of 138 hypertensive patients admitted to our hospital from December 2015 to December 2018 were collected,with 70 patients without heart failure as the hypertension group and68 patients with heart failure as the heart failure group.The left ventricular diastolic end diameter,ventmcular septum,systolic pressure(SBP) and diastolic pressure(DBP) of the two groups were compared.The serum levels of B-type natriuretic peptide(BNP),C-reactive protein(CRP),creatine kinase(CK)-MB,angiotensin(Ang) Ⅱ,cortisol(Cor) and endothelin(ET)-1 were detected and compared between the two groups.The influencing factors of heart failure in the hypertensive elderly were analyzed by multivariate Logistic regression.Results The left ventricular diastolic end diameter,interventricular septum,SBP and DBP in the heart failure group were higher than those in the hypertension group(P <0.05).The levels of BNP,CRP,CK-MB,Ang Ⅱ,Cor and ET-1 in the heart failure group were significantly higher than those in the hypertension group(P <0.05).Multivariate Logistic regression analysis showed that aged 70 years or older,fasting blood glucose ≥7.0 mmol/L,hyperlipidemia,left ventricular hypertrophy,blood pressure control failure were the independent risk factors of heart failure in the elderly with hypertension(P <0.05).Conclusions The elderly hypertensive patients need to control blood pressure strictly and pay close attention to the changes of blood glucose and blood lipid,which can prevent the occurrence of heart failure.