肾性高血压患者血浆前列环素、内皮素与舒张性心力衰竭的危险因素分析

Risk factors of plasma prostacyclin,endothelin and diastolic heart failure in patients with renal hypertension

目的探讨肾性高血压患者血浆前列环素、内皮素与舒张性心力衰竭的危险因素分析。方法选择2016年7月至2019年7月黑龙江省佳木斯市疾病预防控制中心收治的肾性高血压患者60例,根据舒张性心力衰竭诊断标准将患者分为舒张性心力衰竭组38例和心功能正常组22例。对比分析两组患者的一般临床资料、血浆前列环素和内皮素水平,通过单因素和logistic回归模型分析肾性高血压患者的血浆前列环素、内皮素与舒张性心力衰竭的关系。结果舒张性心力衰竭组患者血的浆前列环素、内皮素水平显著高于心功能正常组,差异有统计学意义(P<0.05)。采用单因素回归分析法进行统计学处理发现,吸烟、异常SBP、高水平TC、高水平前列环素和内皮素肾性高血压患者更容易出现舒张性心力衰竭,差异有统计学意义(P<0.05);经过logistic回归分析结果显示,前列环素和内皮素水平异常是引起肾性高血压患者出现舒张性心力衰竭的危险因素。结论前列环素和内皮素与肾性高血压患者出现舒张性心力衰竭存在显著的关系,且血浆前列环素和内皮素可作为预测舒张性心力衰竭的重要标志物。

Objective To investigate the risk factors of plasma prostacyclin,endothelin and diastolic heart failure in patients with renal hypertension.Methods Sixty patients with renal hypertension who were admitted to our hospital from July 2016 to July 2019 were selected and divided into the diastolic heart failure group(n=38)and the normal heart function group(n=22)according to the diagnostic criteria of diastolic heart failure.General clinical data and plasma levels of prostacyclin and endothelin were compared and analyzed between the two groups.The relationship between plasma prostacyclin,endothelin and diastolic heart failure in patients with renal hypertension was analyzed by univariate and logistic regression models.Results Plasma levels of prostacyclin and endothelin in the diastolic heart failure group were significantly higher than those in the normal heart function group,and the differences were statistically significant(P<0.05).The univariate regression analysis showed that smoking,abnormal SBP,high level of TC,high level of prostacyclin and endothelin were more likely to develop diastolic heart failure in renal hypertension patients(P<0.05).The logistic regression analysis showed that abnormal levels of prostacyclin and endothelin were risk factors for diastolic heart failure in patients with renal hypertension.Conclusion Prostacyclin and endothelin have a significant relationship with the occurrence of diastolic heart failure in patients with renal hypertension,and prostacyclin and endothelin can be used as important markers for predicting diastolic heart failure.