高血压合并心力衰竭患者血脂指标及比值与左心室重构的关系研究

目的 探究高血压合并心力衰竭患者血脂指标及比值与左心室重构的关系。方法 选取2019年6月到2022年6月海安市人民医院收治的159例高血压患者作为研究对象。将全部研究对象分为训练集和测试集。收集全部患者一般临床资料，检测血脂指标[总胆固醇（TC），甘油三酯（TG），高密度脂蛋白（HDL-C），低密度脂蛋白（LDL-C）]，并计算TC/HDL-C、TG/HDL-C、LDL-C/HDL-C比值。超声测量患者左心室舒张末期内径（LVEDD）、左室射血分数（LVEF）等，并计算左心室重构指数（LVRI）。多因素Logistic回归分析影响高血压患者发生心力衰竭的危险因素，Pearson相关性分析LVRI与血脂指标及比值关系。结果 训练集中的研究组患者高血压病程、FBG、TG、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、LVEDD高于对照组，HDL-C、LVEF、LVRI低于对照组（P<0.05）。多因素Logistic回归分析显示，训练集高血压病程长、高FBG、高TC、高TC/HDL-C、高TG/HDL-C、高LDL-C/HDL-C、低HDL-C、低LVRI是高血压患者发生心力衰竭的危险因素（P<0.05）。随NYHA分级增加，TG、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C逐渐升高，HDL-C逐渐降低（P<0.05）。Pearson相关性分析显示，LVRI与TG、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C呈正相关，与HDL-C呈负相关（P<0.05）。结论 高血压合并心力衰竭患者血脂水平及比值与左心室重构密切相关，临床需及早防控血脂异常，以降低心力衰竭的发生。

Relationship between blood lipid and left ventricular remodeling in hypertensive patients with heart failure

Objective To investigate the relationship between blood lipid and left ventricular remodeling in hypertensive patients with heart failure. Methods A total of 159 hypertensive patients admitted to our hospital from June 2019 to June 2022 were enrolled as the research objects. All research objects were divided into training set and test set via random method. The general clinical data of all patients were collected the blood lipid indicators (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C)) were detected and the ratio of TC/HDL-C, TG/HDL-C, LDL-C/HDL-C were calculated. Left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured by ultrasound, and left ventricular remodeling index (LVRI) was calculated.Multivariate logistic analysis was used to analyze the risk factors affecting the occurrence of heart failure in patients with hypertension. Pearson correlation analysis was used to analyze the relationship between LVRI and blood lipid indicators and ratios. Results In the training, the course of hypertension, FBG, TG, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, LVEDD in the study group were higher than these in the control group, while HDL-C, LVEF, LVRI in the study group were lower than these in the control group (P<0.05). Multivariate logistic analysis showed that long course of hypertension, high FBG, high TC, high TC/HDL-C, high TG/HDL-C, high LDL-C/HDL-C, low HDL-C, and low LVRI were the risk factors of heart failure in patients with hypertension (P<0.05). With the increase of NYHA grading, the levels of TG, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C were gradually increased, and HDL-C was gradually decreased (P<0.05). Pearson correlation analysis showed that LVRI was positively correlated with TG, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and negatively correlated with HDL-C (P<0.05). Conclusions The blood lipid level in hypertensive patients with heart failure is closely related to left ventricular remodeling. Early prevention and control of dyslipidemia is required in clinical practice to reduce the occurrence of heart failure.