摘要
目的通过病例对照研究的方法探讨难治性高血压(RH)的相关危险因素。方法连续收集服用包括利尿剂在内3种不同降压药物的高血压住院患者247例。根据24 h动态血压监测结果来筛选RH;247例患者分成两组:RH组112例,非RH组135例。记录一般资料及空腹血糖、餐后2小时血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血肌酐、血尿酸、血尿素氮,用彩色超声测量研究对象的左心室舒张期末室间隔厚度(IVST)。用描述分析、t检验、卡方检验、Logistic回归等统计学分析方法对两组数据进行分析。结果 RH组、非RH组体质指数、血肌酐、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、估算肾小球滤过率(e GFR)、IVST差异有统计学意义(P<0.05,P<0.01)。校正性别、年龄、体质指数和病程后,Logistic回归分析和ROC曲线分析显示,IVST、平均动脉压(MAP)、e GFR对血压控制有较好的预测度,其中IVST对血压控制的预测最强,曲线下面积(AUC)为0.663;其次是MAP,AUC为0.600;再其次是e GFR,AUC为0.418。结论 IVST、MAP、e GFR是难治性高血压的危险因素。了解难治性高血压患者的危险因素有助于临床更好地减少靶器官的损害,提高患者的生活质量。
Aim To explore risk factors of resistant hypertension( RH) via the method of case-control.Methods 247 cases of hospitalized patients with hypertension taking three different antihypertensive drugs including diuretics was observed. RH was selected according to the 24 h dynamic blood pressure monitoring. 247 patients were divided into two groups: 112 cases in RH group,135 cases in non RH group. General data,fasting blood glucose( FBG),2 hours postprandial blood glucose( 2h PBG),triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDLC),low density lipoprotein cholesterol( LDLC),serum creatinine( SCr),blood uric acid( BUA) and blood urea nitrogen( BUN) were recorded. Left ventricular end-diastolic interventricular septal thickness( IVST) was measured by color ultrasound. Description analysis,chi-square test,t test and Logistic regression statistical analysis method were used to analyze the data. Results Body mass index( BMI),SCr,TG,TC,HDLC,estimated glomerular filtration rate( e GFR)and IVST had significant difference between RH group and non RH group( P < 0. 05,P < 0. 01). After correction of gender,age,BMI and disease duration,Logistic regression analysis and ROC curve analysis showed that IVST,mean arterial pressure( MAP) and e GFR had good predictability on blood pressure control,IVST was the strongest,the area under curve( AUC) of IVST,MAP,and e GFR was 0. 663,0. 600 and 0. 418 respectively. Conclusions IVST,MAP and e GFR are risk factors for resistant hypertension. Understanding the risk factors in patients with RH can help to reduce damage of target organ and improve the life quality of patients.
出处
《中国动脉硬化杂志》
CAS
北大核心
2015年第1期83-86,共4页
Chinese Journal of Arteriosclerosis
