原发性高血压患者昼夜血压变化差值与血清胆红素水平的关系

Relationship Between Diurnal Blood Pressure Difference and Serum Bilirubin Level in Patients with Essential Hypertension

目的探讨原发性高血压患者昼夜血压变化差值与血清胆红素水平的关系。方法选取2021年1月至12月于河南省人民医院住院的120例原发性高血压患者,根据晨峰血压上升值[清晨起床后2 h内的收缩压(SBP)平均值与夜间睡眠时SBP最低值(夜间血压最低值前后共3次SBP的平均值)的差值]的变化范围进行3分位分组,分为低分位组(25~34 mmHg)(1 mmHg=0.133 kPa)55例、中分位组(35~44 mmHg)45例及高分位组(45~54 mmHg)30例。收集各组性别、年龄、体质量指数(BMI)、血脂、血糖等临床资料,检测总胆红素(T-Bil)、直接胆红素(D-Bil)及间接胆红素(I-Bil)水平。采用Pearson相关分析昼夜血压变化差值与血清胆红素水平的相关性,采用多重线性回归分析昼夜血压变化差值的影响因素。结果各组年龄、BMI、总胆固醇(TG)、甘油三酯(TC)及低密度脂蛋白胆固醇(LDL-C)水平比较,差异有统计学意义(P<0.05);高分位组年龄高于低分位组,BMI、TG高于低分位组和中分位组(P<0.05),高分位组和中分位组TC和LDL-C水平高于低分位组(P<0.05)。高分位组和中分位组T-Bil、D-Bil及I-Bil均低于低分位组,且高分位组T-Bil和I-Bil低于中分位组(P<0.05)。Pearson相关性分析显示,原发性高血压患者昼夜血压变化差值与BMI、TG、TC及LDL-C呈正相关(r=0.459、0.456、0.523、0.459,P<0.05),与T-Bil、D-Bil及I-Bil呈负相关(r=-0.556、-0.523、-0.531,P<0.05)。多重线性回归分析显示,TC、T-Bil、D-Bil及I-Bil是原发性高血压患者昼夜血压变化差值的影响因素(P<0.05)。结论血清胆红素水平越低,昼夜血压变化越明显;血清胆红素水平是原发性高血压患者昼夜血压变化的影响因素。

Objective To explore the relationship between diurnal blood pressure difference and serum bilirubin level in patients with essential hypertension.Methods A total of 120 patients with essential hypertension in Henan Provincial People’s Hospital from Januray 2021 to December 2021 were selected,and accroding to the diurnal blood pressure difference[the difference between the mean value of systolic blood pressure(SBP)within 2 hours after getting up in the morning and the minimum value of SBP at night(the mean value of SBP before and after the minimum value of blood pressure at night)],all subjects were divided into low-level group(25-34 mmHg,n=55)(1 mmHg=0.133 kPa),medium-level group(35-44 mmHg,n=45)and high-level group(45-54 mmHg,n=30).The clinical data of gender,age,body mass index(BMI),blood lipid,glucose were collected,the levels of total bilirubin(T-Bil),direct bilirubin(D-Bil)and indirect bilirubin(I-Bil)were tested among three groups.Pearson correlation analysis and multiple linear regression were used to analyze the correlation between blood pressure difference and serum bilirubin level.Results There were statistically significant differences in age,BMI,triacylglycerol(TG),total cholesterol(TC)and low density lipoprotein cholesterin(LDL-C)among all groups(P<0.05).The age in the high-level group were higher than that in the low-level group,and the BMI and TG were lower than that in the low-level group and the medium-level group(P<0.05).The TC and LDL-C in the high-level group and the low-level group were higher than those in the low-level group(P<0.05).The T-Bil,D-Bil and I-Bil in the high-level group and medium-level group were lower than that in the low-level group(P<0.05),and the T-Bil and I-Bil in the high-level group were lower than that in the medium-level group(P<0.05).Pearson correlation analysis showed that diurnal blood pressure difference was positively correlated with BMI,TG,TC and LDL-C(r=0.459,0.456,0.523,0.459,P<0.05),and was negatively correlated with T-Bil,D-Bil and I-Bil in patients with essential hypertension(r=-0.556,-0.523,-0.531,P<0.05).Multiple linear regression analysis showed that the TC,T-Bil,D-Bil and I-Bil were influence factors for essential hypertension patients(P<0.05).Conclusion The serum bilirubin level is lower,the diurnal blood pressure is more obvious changes,and the serum bilirubin level is an influence factor on diurnal blood pressure changes in essential hypertension patients.