原发性高血压患者心血管危险因素对动脉弹性的影响

Influence of cardiovascular risk factors on arterial elasticity in primary hypertensive patients

摘要:

目的  探讨原发性高血压患者心血管危险因素对动脉弹性的影响，为其临床研究提供可参考依据。方法  选取500例该院就诊的原发性高血压患者作为研究对象，采用颈-桡动脉（C-RPWV）及颈-股动脉（C-FPWV）评价动脉硬化。详细记录患者信息及影响心血管疾病发生的危险因素，分析其与动脉硬化的相关性。结果  500例原发性高血压患者中出现动脉硬化298例，占59.6%。动脉硬化组病程、体重指数（BMI）、低密度脂蛋白（LDL-C）、三酰甘油（TG）、总胆固醇（TC）、C-反应蛋白（CRP）、氨基肽酶N（APN）、C-RPWV、C-FPWV水平明显高于非动脉硬化组，且糖尿病史、吸烟史例数亦多于非动脉硬化组，差异有统计学意义（P <
0.05）；多因素分析发现BMI、LDL-C、TG、TC、CRP水平升高及既往糖尿病史、吸烟史是原发性高血压患者动脉弹性降低的独立危险因素（P <0.05）。相关性分析显示，C-RPWV与BMI、糖尿病史、吸烟史、LDL-C、CRP呈正相关（P <0.05）；C-FPWV与吸烟史、LDL-C、TG、TC呈正相关（P <0.05）。结论  原发性高血压患者C-
RPWV、C-FPWV增加与BMI、LDL-C、TG、TC、CRP水平升高及糖尿病史、吸烟史存在相关性，有效控制心血管疾病发生的影响因素可降低原发性高血压患者动脉硬化的发生风险。

Abstract:

Objective To investigate the influence of cardiovascular risk factors on arterial elasticity in primary hypertensive patients. Methods Five hundred patients with essential hypertension were included. All the patients were tested by brachial ankle pulse wave velocity (baPWV) and ankle arm index (ABI). The information and risk factors of cardiovascular disease were recorded in detail, and their correlations with atherosclerosis were analyzed. Results There were 298 patients with arteriosclerosis in the 500 cases, accounting for 59.6%. The BMI, LDL-C, TG, TC, CRP, APN, C-RPWV and C-FPWV levels in the atherosclerosis group were significantly higher than those in the non-atherosclerosis group (P < 0.05). Multivariable analysis revealed that BMI, LDL-C, TG, TC, elevated CRP levels, history of diabetes and smoking history were independent risk factors of decreased arterial elasticity in patients with primary hypertension (P < 0.05). Correlation analysis showed that C-RPWV had positive correlations with BMI, history of diabetes, smoking history, LDL-C and CRP (P < 0.05), and C-FPW had positive correlations with smoking history, LDL-C, TG and TC (P < 0.05). Conclusions The decrease of arterial elasticity is closely related with BMI, LDL-C, TG, TC, elevated CRP level, diabetes history and smoking history in the elderly patients with hypertension. The effective control of the influence factors of cardiovascular diseases can reduce the risk of occurrence of arteriosclerosis in essential hypertension patients.