摘要
目的探讨正常高值血压人群和正常血压者发生颈动脉结构异常和大动脉硬化的差异,并分析两组人群颈动脉结构异常与大动脉硬化的关系。方法入选2017年1月至2019年3月在福建医科大学附属第一医院就诊的非高血压患者581例,分为正常高值血压组(n=270)和正常血压组(n=311)。所有受检者测量身高、体质量、血压和静息心率,测定血生化指标,进行颈动脉超声检查和颈股动脉脉搏波传导速度(cfPWV)检测。将颈动脉内膜中层厚度(IMT)≥1.0 mm定义为IMT增厚,颈动脉IMT增厚和/或存在颈动脉斑块定义为颈动脉结构异常,cfPWV≥10.0 m/s定义为大动脉硬化。结果与正常血压组相比,正常高值血压组的颈动脉结构异常患者百分比(60.7%比51.4%)、cfPWV[(8.78±1.48)比(7.92±1.30)m/s]、大动脉硬化患者百分比(13.7%比5.8%)明显增高(均P<0.05)。在正常高值血压组中,与颈动脉结构正常受检者(n=106)比较,颈动脉结构异常受检者(n=164)的大动脉硬化患者百分比明显升高(20.1%比3.8%,χ2=14.551,P<0.001)。在正常高值血压组中,单因素logistic回归分析显示,颈动脉结构异常、年龄、糖尿病、静息心率、收缩压、空腹血糖、糖化血红蛋白(HbA1c)、服降糖药与大动脉硬化相关(均P<0.05);多因素logistic回归模型在校正了其他心血管病危险因素的影响后显示,颈动脉结构异常、年龄、糖尿病、静息心率与大动脉硬化独立相关,颈动脉结构异常者发生大动脉硬化的风险是颈动脉结构正常者的5.25倍(OR=5.250,95%CI 1.580~17.448,P=0.007)。而在正常血压组中,颈动脉结构异常与大动脉硬化无独立相关。结论在正常高值血压人群中,颈动脉结构异常和大动脉硬化明显增加,并且两者独立相关。
Objective To investigate the difference of carotid structural abnormality and arterial stiffness and the relationship of carotid structural abnormality with arterial stiffness between prehypertensive and normotensive subjects. Methods A total of 581 participants [270 with prehypertension, 311 normotensive subjects(controls)] from the First Affiliated Hospital of Fujian Medical University were enrolled from January 2017 to March 2019. Body height/weight, resting heart rate and blood pressure were recorded. Blood biochemical indexes and carotid-femoral pulse wave velocity(cfPWV) were determined and carotid ultrasonography was performed. Carotid intima-media thickness(IMT)≥1.0 mm was defined as IMT thickening, carotid IMT thickening and/or plaque formation as carotid structural abnormalities and cfPWV≥10.0 m/s as arterial stiffness. Results The percentage of patients with carotid structural abnormality(60.7% vs 51.4%), cfPWV[(8.78±1.48)vs(7.92±1.30)m/s], and the percentage of patients with arterial stiffness(13.7% vs 5.8%) in the prehypertension group were increased compared to the control group(all P<0.05). In the prehypertension group, the percentage of patients with arterial stiffness in the abnormal carotid structure subgroup(n=164) was higher than that in the normal carotid structure subgroup(n=106)(20.1% vs 3.8%, χ~2=14.551, P<0.001). In the prehypertension group, univariate logistic regression analysis showed that carotid structural abnormality, age, diabetes mellitus, resting heart rate, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin A1 c and hypoglycemic therapy were all correlated with arterial stiffness(all P<0.05). After adjusting for other cardiovascular risk factors, multiple logistic regression analysis showed that carotid structural abnormality, age, diabetes mellitus and resting heart rate were independently correlated with arterial stiffness and the patients with carotid structural abnormality had 5.25 fold higher risk of arterial stiffness than with normal carotid s
作者
张玲玉
李建华
沈逸华
徐国焱
韩英
谢良地
ZHANG Ling-yu;Li Jian-hua;SHEN Yi-hua;XU Guo-yan;HAN Ying;XIE Liang-di(General Practice Department,The First Affiliated Hospital of Fujian Medical University,Fuzhou Fujian 350005,China;不详)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2020年第12期1179-1185,共7页
Chinese Journal of Hypertension
基金
福建省科技厅引导性项目(2017Y0034)
福建省科技厅自然科学基金项目(2018J01166)。
