原发性高血压患者血浆纤维蛋白原含量与血压水平的相关性分析

目的 探讨血浆纤维蛋白原水平与原发性高血压患者血压水平的关系，明确原发性高血压患者血压显著升高的危险因素及其相关性。方法 选取2012年9月至2014年12月郑州大学第一附属医院收治的258例原发性高血压患者，按血压控制水平分为正常血压组（68例）、1级高血压组（63例）、2级高血压组（79例）、3级高血压组（48例）。采用Kruskal-Wallis检验及Mann-Whitney U检验比较4组纤维蛋白原血浆水平。采用logistic回归分析筛选促使血压显著升高的影响因素。利用Spearman相关分析纤维蛋白原与这些影响因素的相关性。结果 3级高血压组的血浆纤维蛋白原水平与其他3组比较，差异有统计学意义（P<0.01），而其他3组间纤维蛋白原水平的差异无统计学意义（P>0.05）。logistic回归分析显示，血糖升高（OR=2.746，P=0.004）、胆固醇升高（OR=2.169，P=0.037）、肌酐升高（OR=2.711，P=0.011）以及尿酸升高（OR=2.975，P=0.002）是3级高血压形成的重要危险因素。Spearman相关分析结果显示纤维蛋白原与血糖、胆固醇及尿酸无相关性（P>0.05），仅与血肌酐呈弱相关（r=0.173，P=0.005）。结论 纤维蛋白原水平升高是血压升高的促进因素。血糖、胆固醇、肌酐及尿酸水平的升高对于极高危高血压（3级高血压）的形成有促进作用。

Research on the correlation between blood pressure and plasma fibrinogen level of patients with essential hypertension

Objective To study the correlation between blood pressure and plasma fibrinogen levels in those patients with essential hypertension, and to identify the promoting factors of severe hypertension and association of which with fibrinogen. Methods 258 cases of patients with essential hypertension, admitted to our hospital from Sep 2012 to Dec 2014, were selected and divided into three groups according to their blood pressure levels:the normal pressure group of 68 cases, the grade 1 hypertension group of 63 cases, the grade 2 hypertension group of 79 cases and the grade 3 hypertension group of 48 cases. The plasma fibrinogen levels of patients in the 4 groups were compared by Kruskal-Wallis test and Mann-Whitney U test, and the promoting factors of severe hypertension and association of which with fibrinogen were identified by logistic regression analysis and Spearman correlation analysis, respectively. Results The fibrinogen levels of patients in the grade 3 hypertension group were significantly higher than the results of patients in the other 3 groups (all P<0.01), but differences among the other 3 groups were not statistically significant (all P>0.05). Logistic regression analysis showed that elevated levels of blood glucose (OR=2.746, P=0.004), cholesterol (OR=2.169, P=0.037), creatinine (OR=2.711, P=0.011) and uric acid (OR=2.975, P=0.002) were important promoting factors of grade 3 hypertension development. Spearman correlation analysis indicated that fibrinogen level was unrelated with blood glucose, cholesterol and uric acid, and in weak correlation with blood creatinine. Conclusion Higher fibrinogen level is a promoting factor of blood pressure increase, and elevated levels of blood glucose, cholesterol, creatinine and uric acid all promote the severe hypertension (hypertension grade 3) development.