原发性高血压并发心脑血管疾病患者的危险因素分析

目的：研究原发性高血压（EH）伴冠心病和／或脑血管病患者的临床特点，分析其相关的危险因素。方法：对55例EH伴冠心病和／或脑血管病患者，进行动脉硬化指数（ASI）测定，并检测患者的血尿酸、血糖、血脂、肌酐、尿素氮等血液生化指标及一般情况。另选不伴有冠心病、脑血管病的高血压患者63例作为对照。结果：与单纯高血压对照组比较，EH伴冠心病和／或脑血管的年龄大、病史时间长，ASI、脉压、血尿素氮水平明显升高（均P〈0.01）；收缩压、血尿酸、总胆固醇、肌酐水平也升高（均P〈0．05）；而舒张压（P〈0．01），心率（P〈0．05）却较低。多因素logistic回归分析显示：EH并发心脑血管疾病的相关危险因素有脉压、血肌酐、年龄（OR=1．204，1．120，1．099,P=0．028，0．045，0．039）；而血尿酸是负相关因素（OR=0．974，P=0．022）。结论：脉压、血肌酐水平和年龄可能是高血压患者并发心脑血管疾病的危险因素；血尿酸可能是一种保护因素。

Analysis of risk factors of patients with essential hypertension complicating cardiovascular and/or cerebrovascular diseases

Objective:To investigate the clinical characteristics of patients with essential hypertension(EH) complicating coronary heart diseases and/or cerebral vascular diseases and analyze risk factors about it.Methods:A total of 118 EH patients were recruited and divided into two groups:simple EH patient group (n=63) and group of EH patients complicating coronary hear diseases(CHD) and/or cerebral vascular diseases(n=55).The demographic characteristics, arterial stiffness index(ASI) and blood biochemical parameters were measured and compared between the two groups.Results:Comparing with simple EH patients,there were older age, longer hypertensive history,higher values of arterial stiffness index,pulse pressure, serum creatinine (all P<0.01), higher values of systolic blood pressure,blood uric acid,total cholesterol, blood urea nitrogen (all P<0.05),but lower values of diastolic blood pressure(P<0.01),heart rate (P<0.05) in the group of EH patients complicating CHD and/or CVD.Logistic regression analysis showed that pulse pressure,serum creatinine and age (OR=1.204,1.120,1.099;P=0.028,0.045,0.039,respectively) were positive risk factors,but the blood uric acid was a negative factor (OR=0.974,P=0.022) for the EH patients complicating CHD and/or CVD.Conclusion:The pulse pressure, serum creatinine and age may be independent risk factors and blood uric acid may be a protective factor for EH patients complicating CHD and/or CVD.