H型高血压患者发生射血分数保留心力衰竭的危险因素分析

Analysis of risk factors for heart failure with preserved ejection fraction in patients with type H hypertension

目的探讨H型高血压患者发生射血分数保留心力衰竭(HFpEF)的相关危险因素,为预防HFpEF发生提供参考依据。方法回顾性分析2015年1月至2019年1月于秦皇岛市第一医院心血管内科门诊就诊及住院治疗的200例H型高血压发生HFpEF患者的临床资料,作为研究组,选取同期80例H型高血压合并射血分数正常非心衰患者记为对照组。比较两组患者基本临床信息的差异情况,并采用Logistic逐步回归分析H型高血压患者发生HFpEF的危险因素。结果两组性别构成比、年龄、吸烟史、高血压分级以及合并肥胖症、糖尿病、冠状动脉粥样硬化性心脏病(冠心病)、慢性阻塞性肺疾病(COPD)、心房纤颤(房颤)、睡眠呼吸暂停综合征(SAHS)率比较,差异均有统计学意义(P<0.05),组间左室射血分数(LVEF)、左室舒张末期内径(LVDd)、左室舒张期末室间隔厚度(IVST)、左房容积(LAV)和N末端脑钠肽前体(NT-proBNP)水平比较差异也有统计学意义(P<0.01)。多因素Logistic回归分析显示,女性、高龄、吸烟、高血压Ⅲ级、肥胖症、糖尿病、冠心病、COPD均是H型高血压患者发生HFpEF的危险因素。结论高龄、女性、高血压分级较高及合并肥胖症、糖尿病、冠心病、COPD疾病等因素会增加H型高血压患者发生HFpEF的风险,应结合患者上述因素的具备情况采取相应预防治疗等干预措施,努力降低HFpEF发生风险。

Objective To explore the risk factors of heart failure with preserved ejection fraction(HFpEF)in patients with H-type hypertension,and to provide reference for preventing HFpEF.Methods The clinical data of 200 patients with HFpEF caused by H-type hypertension in the First Hospital of Qinhuangdao from January 2015 to January 2019 were retrospectively analyzed as study group.80 patients with H-type hypertension complicated with normal ejection fraction and non-heart failure in the same period were selected as the control group.The differences in basic clinical information between the two groups of patients were compared,and logistic stepwise regression was used to analyze the risk factors of HFpEF in patients with H-type hypertension.Results There were statistically significant differences in gender composition ratio,age,smoking history,grade of hypertension,and rates of obesity,diabetes,coronary heart disease,COPD,atrial fibrillation,and SAHS between the two groups(P<0.05).The differences in the levels of LVEF,LVDd,IVST,LAV and NT-proBNP between the groups were also statistically significant(P<0.01).Multivariate logistic regression analysis showed that women,old age,smoking,hypertension grade III,obesity,diabetes,coronary heart disease,COPD are all risk factors for HFpEF in patients with type H hypertension.Conclusion The risk of HFpEF in patients with H-type hypertension is increased by factors such as old age,women,high grade of hypertension,obesity,diabetes mellitus,coronary heart disease,COPD disease and so on.The intervention measures such as prevention and treatment should be taken to reduce the risk of HFpEF according to the above factors.