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中心性肥胖高血压患者左室肥厚危险因素分析

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摘要:

目的 探析中心性肥胖合并高血压患者左室肥厚(LVH)的影响因素,为防治肥胖相关 性高血压的心脏损害提供思路。方法 收集2015年5月至2016年2月于岳阳中西医结合医院门诊及住院 的227例中心性肥胖合并高血压病患者的临床资料,根据有无LVH将患者分为LVH组(n=70)和非LVH 组(n=155)。采用单因素及非条件Logistic回归对影响LVH发生的因素进行分析。结果 单因素分析 结果显示,两组患者的年龄、性别、腰臀比(WHtR)、高尿酸血证、尿微量白蛋白(MA)、脑钠肽 (BNP)、超敏C反应蛋白(hs-CRP)、血压分级、教育程度比较,差异有统计学意义(P<0.05)。 非条件Logistic回归分析发现,MA升高(OR=3.429,95%CI:1.812~6.488)、高尿酸血证(OR=2.109, 95%CI:1.037~4.294)、hsCRP升高(OR=1.351,95%CI:1.054~1.733)、WHtR升高(OR=1.466, 95%CI:1.100~1.954)以及女性患者(OR=1.973,95%CI:1.053~3.679)增加了中心性肥胖合并高血压 患者LVH发生的风险,教育程度提升(OR=0.665,95%CI:0.485~0.910)可降低LVH发生的风险。结论 中心性肥胖高血压患者LVH与多种因素相关,控制尿MA、hs-CRP、WHtR水平,改善高尿酸血证,提升 教育程度的可能有助于降低LVH发生的风险。

Abstract:

Objective To analyze the influencing factors of left ventricular hypertrophy (LVH) in patients with central obesity-hypertension, and provide ideas for preventing and treating obesity-related hypertension. Methods The clinical materials were collected from 227 patients with central obesity-hypertension in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from May 2015 to Feb. 2016. All patients were divided, according to whether they had LVH or not, into LVH group (n=70) and non-LVH group (n=155). The influencing factors of LVH were analyzed by using single-factor and unconditional Logistic regression analysis. Results The results of single-factor analysis showed that the difference in age, sex, waist hip ratio (WHR), hyperuricacidemia, urinary micro albuminuria (U-mAlb), B-type natriuretic peptide (BNP), high sensitivity C-reactive protein (hs- CRP), blood pressure classification and education background had statistical significance between 2 groups (P<0.05). The results of unconditional Logistic regression analysis showed that increased U-mAlb (OR=3.429, 95%CI: 1.812~6.488), hyperuricacidemia (OR=2.109, 95%CI: 1.037~4.294), increased hs-CRP (OR=1.351, 95%CI: 1.054~1.733), increased WHR (OR=1.466, 95%CI: 1.100~1.954), female (OR=1.973, 95%CI: 1.053~3.679) increased the risk of LVH in patients with central obesity-hypertension, while promotion of educational degree (OR=0.665, 95%CI: 0.485~0.910) decreased the risk of LVH incidence. Conclusion LVH is correlated to multiple factors in patients with central obesity-hypertension, and controlling of U-mAlb, hs-CRP, WHR and hyperuricacidemia, and promoting of educational degree can reduce LVH risk.

基金项目:

国家自然科学基金(81803892,81774111);上海市科学技术委员会科研计划项目(19401970400);上海市进一步加快中医药事业发展三年行动计划(ZY3-CCCX-3-3026)

参考文献:

  • 2008

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