原发性高血压患者血清总胆红素水平与左心室肥厚的相关性研究

Relationship between serum total bilirubin levels and left ventricular hypertrophy in patients with essential hypertension

目的分析初诊或未治疗的原发性高血压患者血清总胆红素水平与左心室肥厚的关系。方法选取2015年1至8月在鹤山市人民医院就诊资料完整的新发原发性高血压患者200例,根据左心室质量指数分为左心室肥厚组(58例)及左心室正常组(142例)。比较两组患者的一般临床资料、生化指标和超声心动图参数,并采用单因素和多因素回归分析左心室肥厚的相关因素。结果在原发性高血压患者中,左心室肥厚组血清总胆红素水平明显低于左心室正常组[(22.47±6.75)U/L vs.(33.24±5.84)U/L],单因素分析结果表明,收缩压(OR=1.569,95%CI 1.125~2.896;P=0.002)和年龄(OR=1.372,95%CI 1.103~1.925;P=0.047)是左心室肥厚的危险因素,而血清总胆红素(OR=0.586,95%CI 0.259~0.852;P=0.001)是左心室肥厚的保护因素,进一步多因素Logistic回归分析表明,血清总胆红素(OR=0.459,95%CI 0.231~0759;P=0.018)仍是左心室肥厚的保护因素。结论原发性高血压患者血清总胆红素是左心室肥厚的保护因素,监测血清总胆红素变化可能对早期发现左心室重构有一定意义。

Objective To analyze the relationship between serum total bilirubin level and left ventricular hypertrophy in essential hypertension patients newly diagnosed or untreatment.Methods Two hundred newly diagnosed essential hypertension patients were from Heshan People's Hospital from January 2015 to August 2015.They were divided into none left ventricular hypertrophy(142 cases) and left ventricular hypertrophy group(58 cases) based on left ventricular mass index.The clinical data,biochemical indicators and ultrasonic cardiogram parameters between groups were compared,and univariate and multivariate Logistic regression analysis were used for finding the related factors for left ventricular hypertrophy.Results The serum total bilirubin level was significantly lower in left ventricular hypertrophy group than none left ventricular hypertrophy group [(22.47±6.75) U/L vs.(33.24±5.84) U/L].The univariate Logistic analysis showed that serum total bilirubin(OR=0.586,95% CI 0.259-0.852;P=0.001) was a protective factor for left ventricular hypertrophy,while age(OR=1.372,95% CI1.103-1.925;P=0.047) and systolic blood pressure(OR=1.569,95% CI 1.125-2.896;P=0.002) were risk factors.Multiple Logistic analysis showed that serum total bilirubin(OR=0.459,95% CI 0.231-0759;P=0.018) was still a protective factor for left ventricular hypertrophy.Conclusion Serum total bilirubin is a protective factor for left ventricular hypertrophy,and monitoring the changes of serum total bilirubin may has significant effect on the early detection of left ventricular hypertrophy.