非酒精性脂肪肝并发原发性高血压患者与血压变异性的关系

Correlation between non-alcoholic fatty liver disease and blood pressure variability in patients with hypertension

目的探讨非酒精性脂肪肝(Non-alcoholic Fatty Liver Disease,NAFLD)并发原发性高血压对血压变异性的影响。方法纳入在2019年9月~2020年7月就诊于宣城市人民医院心血管内科的原发性高血压患者206例,进行动态血压、动态心电图及腹部超声检查。以动态血压测量参数中24 h收缩压变异性和24 h舒张压变异性作为血压变异性指标。根据是否有NAFLD将患者分为非NAFLD并发高血压组(n=148)和NAFLD并发高血压组(n=58);应用多元线性回归分析原发性高血压并发NAFLD与血压变异性之间的关系。结果两组的性别与高血压等绝大多数指标差异无统计学意义。与非NAFLD组相比,NAFLD组的年龄指标降低(P<0.05);HDL-C降低(P<0.01),甘油三酯、丙氨酸氨基转移酶和r-谷氨酰基转移酶指标升高(P<0.01);与非NAFLD组相比,NAFLD组的24 h舒张压标准差升高(P<0.01);24 h舒张压变异性升高(P<0.05)。多元线性回归分析显示,NAFLD是24 h舒张压变异性的影响因素(B=0.220,P=0.003),而NAFLD对患者的24 h收缩压变异性无影响。结论在原发性高血压患者中,NAFLD可能是24 h舒张压变异性的影响因素。

AIM To determine the relationship between non-alcoholic fatty liver disease(NAFLD)and blood pressure variability.METHODS Patients with primary hypertension admitted in the Department of Cardiology,People’s Hospital of Xuancheng from September 2019 to July 2020 were included for this study and ambulatory blood pressure,24 hours dynamic electrocardiogram and abdominal sonography were performed.The standard deviation of the 24-hour diastolic blood pressure variability and the 24-hour systolic blood pressure variability were regarded as the blood pressure variability.The patients were divided into NAFLD group(n=58)and non-NAFLD group(n=148).Multiple linear regression analysis was used to analyze the relationship between non-alcoholic fatty liver disease and blood pressure variability.RESULTS A total of 206 patients were selected.(1)Age and high-density lipoprotein in NAFLD group were lower than those in non-NAFLD group(P<0.05).Triglyceride,alanine aminotransferase and r-glutamyl transferase in NAFLD group were higher than those in non-NAFLD group(P<0.01).Those with NAFLD had higher Diastolic blood pressure variability and 24 hours diastolic blood pressure standard deviation in NAFLD group were also higher than those in non-NAFLD group(P<0.05).Multiple linear regression analysis showed that NAFLD(B=0.220,P=0.003)was an influencing factor of 24 h diastolic blood pressure variability.NAFLD had no effect on 24 h systolic blood pressure variability.CONCLUSIONS NAFLD is an influencing factor for diastolic blood pressure variability in patients with primary hypertension.