颈动脉内膜中层厚度与青年肥胖及高血压的相关性分析

Correlation of carotid intima-media thickness with youth obesity and hypertension

目的研究不同肥胖度下高血压与颈动脉内膜中层厚度(IMT)的相关性。方法选取2014年3~10月在河北北方学院附属第一医院就诊的肥胖和/或高血压青年患者120例,按体质量指数(BMI)分为Ⅰ组25例、Ⅱ组41例、Ⅲ组44例、Ⅳ组10例,其中1级高血压44例、2级高血压52例、3级高血压24例。比较不同高血压水平及肥胖度患者的颈动脉斑块检出率和IMT,经Spearman秩检验分析肥胖前状态(BMI<30.0 kg/m2)及肥胖(BMI≥30.0 kg/m2)患者收缩压(SBP)、舒张压(DBP)与IMT的相关性。结果斑块检出率、IMT均随着高血压及肥胖度的增加而逐渐增加,且各组间斑块检出率、IMT比较差异均有显著统计学意义(P<0.01);当BMI<30.0 kg/m2时,SBP与IMT呈显著正相关(r=0.886,P=0.000),而DBP与IMT无相关性(r=0.319,P=0.086);当BMI≥30.0 kg/m2时,SBP和DBP与IMT均呈显著正相关(r=0.767,P=0.000;r=0.394,P=0.001)。结论高血压和肥胖均可导致IMT增加,肥胖前状态患者SBP与IMT及肥胖患者SBP和DBP与IMT均呈显著正相关,IMT可为预测青年肥胖及高血压患者心血管疾病的发生、发展及预后提供理论依据。

Objective To explore the correlation of carotid intima-media thickness(IMT) with youth obesity and hypertension. Methods A total of 120 youth patients with obesity and/or hypertension, who admitted to the First Affiliated Hospital of Hebei North University from March 2014 to October 2014, were selected and divided into groupⅠ(n=25), groupⅡ(n=41), groupⅢ(n=44), groupⅣ(n=10) according to body mass index(BMI). Among them, there were44 cases of grade 1 hypertension, 52 cases of grade 2 hypertension and 24 cases of grade 3 hypertension. The detection rate of carotid artery plaque and IMT in patients with different levels of hypertension and obesity were compared, and the correlation of IMT with diastolic blood pressure(DBP) and systolic blood pressure(SBP) in obese patients(BMI≥30.0 kg/m2) and pre-obese patients(BMI<30.0 kg/m2) was analyzed by Spearman rank test. Results The carotid artery plaque detection rate and IMT increased as the grades of hypertension and obesity increased, and there were significant differences among the carotid artery plaque detection rate and IMT of different groups(P<0.01). When BMI<30.0 kg/m2,IMT and SBP showed a significant positive correlation(r=0.886, P=0.000), while there was no significant correlation between DBP and IMT(r=0.319, P=0.086). When BMI≥30.0 kg/m2, there were significant correlation between IMT and SBP, DBP(r=0.767, P=0.000; r=0.394, P=0.001). Conclusion Hypertension and obesity can lead to the increase of IMT and SBP of pre-obese patients, and SBP and DBP of obesity patients are significantly positively correlated with IMT. IMT can provide theoretical basis for the prediction of occurrence, development and prognosis of cardiovascular of youth obesity and hypertension patients.