伴糖耐量异常的原发性高血压患者血尿酸与颈动脉硬化、动脉僵硬度的相关性研究

Correlation with uric acid and arterial stiffness and carotid atherosclerosis in patients with essential hypertension and abnormal glucose tolerance

目的观察合并糖耐量异常原发性高血压患者尿酸水平对颈动脉硬化及动脉僵硬度的影响。方法选取2012年12月—2013年9月就诊的原发性高血压患者513例,根据空腹血糖及餐后2 h血糖分为糖耐量正常组267例、糖耐量异常组246例,通过一般资料的收集、血清学指标检测及动脉僵硬度相关指标的测定,观察尿酸对糖耐量异常的原发性高血压患者颈动脉硬化及动脉僵硬度的影响。结果 2组尿酸、空腹血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、碱性磷酸酶、糖化血红蛋白比较,差异均有统计学意义(t值分别为-11.732、-9.657、-3.033、2.934、-3.183、-4.531、-2.271、-5.093,P均<0.05),内膜中层厚度(IMT)、肱踝脉搏波传导速度(BaPWV)及斑块发生率之间比较差异亦有统计学意义(t/X^2值分别为-3.999、-4.713、6.907,P均<0.05),但左右两侧IMT、BaPWV均无明显统计学差异(t值分别为-3.604、-3.729,-4.496、-4.810,P均>0.05),而AB1差异无统计学意义。BaPWV的多元Logisti回归分析示年龄、尿酸为动脉僵硬度的独立危险因素(分别为OR=1.115,95%CI 1.084~1.146,OR=1.004,95%CI 1.000~1.007,P均<0.05)。结论对于合并有糖耐量异常的原发性高血压患者,应积极控制其血尿酸及血糖水平,以减少动脉硬化程度,从而防止心血管恶性事件的发生。

Objective To observe the influence of the level of uric acid in essential hypertension(EH) patients complicated with abnormal glucose tolerance on carotid atherosclerosis and arterial stiffness.Methods From 2012 December to2013 September,513 patients with EH were enrolled,according to the fasting blood glucose(FBG) and postprandial 2 h blood glucose(2 hPG),these patients were divided into normal glucose tolerance group of 267 cases,abnormal glucose tolerance group of 246 cases,through the determination of the general data collection,serological detection and artery stiffness related indicators,observe the influence of the level of uric acid in abnormal glucose tolerance EH patients on carotid artery atherosclerosis and arterial stiffness.Results Compared the 2 groups of patients' uric acid,FBG,total cholesterol,HDL-C,LDL-C,apolipoprotein B,alkaline phosphatase,glycosylated hemoglobin and comparison,the differences were statistically significant(t =-11.732,-9.657,-3.033,2.934,-3.183,-4.531,-2.271,-5.093,P <0.05),the difference among intima-media thickness(IMT),brachial ankle pulse wave velocity(BaPWV) and plaque incidence rate also have statistical significance(t =-3.999,t =-4.713.x^2 =6.907,P <0.05),but no statistically significant difference of IMT,baPWV between left and right sides(t =-3.604,-3.729,-4.496,-4.810,P >0.05),there were statistically significant differences of ABI.BaPWV' s multivariate Logistic regression analysis indicated that age,uric acid were the independent risk factors for arterial stiffness(OR = 1.115,95%CI 1.084-1.146,OR = 1.004,95%CI 1.000- 1.007,P <0.05).Conclusion EH patients with abnormal glucose tolerance should actively control the blood uric acid and blood glucose levels,reduce the degree of arteriosclerosis,prevent the occurrence of cardiovascular and malignant events.