摘要
目的 探讨原发性高血压(EH)合并代谢综合征(MS)患者肱踝动脉脉搏波传导速度(baPWV)与血浆肾素活性(PRA)的关系及动态血压不达标的影响因素。方法 根据是否合并MS,将263例EH患者分为无MS组118例和MS组145例。比较两组患者一般临床资料、PRA、baPWV及动态血压,采用Pearson相关分析评估baPWV与PRA及其他指标的相关性,采用二元logistic回归分析评估动态血压不达标的影响因素。结果 MS组患者BMI、腹围、空腹血糖(FPG)、糖负荷后2 h血糖(2h PG)、甘油三酯、血尿酸水平及左、右侧baPWV均高于无MS组,高密度脂蛋白胆固醇(HDL-C)水平低于无MS组(P<0.05)。Pearson相关分析结果显示,EH患者baPWV与FPG、2h PG均呈正相关(P<0.001),与估算的肾小球滤过率(eGFR)呈负相关(P<0.001),与PRA无相关性(P=0.403);MS组患者baPWV与PRA呈负相关(P=0.020);而无MS组患者baPWV与PRA无相关性(P=0.632)。二元logistic回归分析结果显示,eGFR是无MS组患者动态血压不达标的独立保护因素(P=0.025),baPWV是其独立危险因素(P=0.045),而年龄是MS组患者动态血压不达标的独立危险因素(P=0.017)。结论 EH合并MS患者PRA越低,其动脉弹性越差。无MS的EH患者动态血压不达标的危险因素包括eGFR降低和baPWV升高,而年龄对EH合并MS患者动态血压不达标有独立影响。
Objective To explore the relationship between brachial⁃ankle artery pulse wave conduction velocity(baPWV)with plasma renin activity(PRA)and influencing factors of ambulatory blood pressure control failure in patients with essential hypertension(EH)and metabolic syndrome(MS).Methods A total of 263 patients with EH were divided into non⁃MS group(118 cases)and MS group(145 cases)according to whether combined with MS or not.General clinical data,PRA,baPWV and ambulatory blood pressure were compared between two groups.Pearson correlation analysis was used to evaluate correlation between baPWV with PRA and other indexes.Binary logistic regression analysis was used to evaluate influencing factors of ambulatory blood pressure control failure.Results BMI,abdominal circumference,fasting plasma glucose(FPG),2 h plasma glucose post⁃glycemic load(2h PG),triglyceride,serum uric acid levels and left,right baPWV of patients in MS group were higher than those in non⁃MS group,high density lipoprotein cholesterol(HDL⁃C)was lower than that in non⁃MS group(P<0.05).Pearson correlation analysis showed that baPWV was positively correlated with FPG and 2h PG(P<0.001),and negatively correlated with estimated glomerular filtration rate(eGFR)(P<0.001),while it was not correlated with PRA(P=0.403)in patients with EH;baPWV was negatively correlated with PRA of patients in MS group(P=0.020);while there were no correlation between baPWV with PRA of patients in non⁃MS group(P=0.632).Binary logistic regression analysis showed that eGFR was an independent protective factor for ambulatory blood pressure control failure of patients in non⁃MS group(P=0.025),baPWV was an independent risk factor of it(P=0.045),while age was an independent risk factor for ambulatory blood pressure control failure of patients in MS group(P=0.017).Conclusion The lower the PRA,the worse the arterial elasticity in patients with MS and EH.Risk factors for ambulatory blood pressure conduct failure includes eGFR reduction and baPWV increase in EH patients witho
作者
钟婧捷
余振球
Zhong Jingjie;Yu Zhenqiu(Department of Hypertension,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)
出处
《临床内科杂志》
CAS
2024年第2期100-103,共4页
Journal of Clinical Internal Medicine
基金
贵州省卫生健康委员会科学技术基金项目(gzwjkj2019-1-056)。
关键词
原发性高血压
代谢综合征
血浆肾素活性
脉搏波传导速度
动态血压
Essential hypertension
Metabolic syndrome
Plasma renin activity
Pulse wave conduction velocity
Ambulatory blood pressure
