老年高血压患者颈动脉粥样硬化的影响因素分析

目的分析老年高血压患者颈动脉粥样硬化(CAS)的影响因素。方法选取2016年1月至2017年6月安徽省第二人民医院的高血压患者110例,所有患者均行颈动脉超声检查测量颈动脉内膜中层厚度(IMT),根据检查结果将患者分为IMT正常组(44例)和IMT异常组(66例)。分别检测并比较两组患者的空腹血糖(FPG)、血脂、同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP),并行24 h动态血压监测,比较两组患者24 h血压差异。采用logistic回归分析CAS的影响因素。结果与IMT正常组相比,IMT异常组的总胆固醇(TC)、低密度脂蛋白(LDL-C)、Hcy、hs-CRP、血压变异性、血压晨峰检出率升高,差异有统计学意义(P<0.05);两组患者FPG、三酰甘油(TG)、HDL-C比较,差别无统计学意义(P>0.05)。logistic逐步回归分析结果显示,TC、Hcy、hs-CRP、24 h平均收缩压的标准差(SSD)、有无血压晨峰为CAS形成的危险因素(P<0.05)。IMT异常组存在≥3个危险因素的患者的比例高于IMT正常组,差异有统计学意义(P<0.05)。结论 TC、Hcy、hs-CRP、SSD、血压晨峰与CAS有关,是导致CAS发生发展的危险因素;患者合并危险因素越多,存在CAS的风险更大。

The influencing factors of carotid atherosclerosis with hypertension in elderly patients

Objective To investigate the influencing factors of carotid atherosclerosis(CAS) in elderly patients. Methods A total of 110 patients with hypertension who were admitted in Anhui No.2 Provincial People''s Hospital from January 2016 to June 2017 were enrolled in the study. All patients were examined by color Doppler Ultrasound to measure intima-media thickness of carotid artery(IMT). The patients were divided into normal IMT group and abnormal IMT group.The biochemical indexes including fasting plasma glucose(FPG), blood lipids, homocysteine(Hcy), high sensitivity C-reactive protein (hs-CRP), and 24-hour ambulatory blood pressure monitoring were checked and the difference was analyzed. Logistic Regression was used to analyse those factors with statistical difference. Results Compared with normal IMT group, the level of total cholesterol (TC), low density lipoprotein (LDL-C), Hcy, hs-CRP, the detection rate of blood pressure morning surge(BPMS), variability of blood pressure (BPV) of abnormal IMT group increased, which showed significant difference (P<0.05). But the level of FPG, triglycerides (TG), high density lipoprotein (HDL-C) showed no significant difference. As to those factors which showed significant difference, Logistic regression analysis showed that TC, Hcy, hs-CRP, standard deviation of systolic blood pressure(SSD) and BPMS were the risk factors of CAS (P<0.05). The proportion of patients in abnormal IMT group with more than three risk factors was significantly higher than that of normal IMT group(P<0.05). Conclusions TC, Hcy, hs-CRP,SSD, BPMS in elderly patients with hypertension are correlated to IMT, which are the risk factors in the pathogenesis and development of CAS. The more risk factors, the greater the influence of CAS.