CAJ | 학술논문

目的探讨正常高值血压的危险因素及血压与动脉硬化的相关性.方法对2011年6月至2012年6月在本院综合医疗科入院体检人群456例进行横断面分析,其中理想血压组174例、正常高值血压组282例,包括人口学特征、血压、血液生化代谢指标、臂踝脉搏波传导速度(baPWV)、踝臂指数(ABI)及颈动脉内膜中层厚度(CIMT)等.结果与理想血压组相比,正常高值血压组收缩压、舒张压、脉压、体质量指数、空腹血糖、糖化血红蛋白、甘油三酯、尿酸、C反应蛋白水平明显升高(P＜0.05),而高密度脂蛋白明显降低(P＜0.05);体质量指数(OR=1.185)、甘油三酯(OR =1.302)、空腹血糖(OR=1.690)为正常高值血压的独立危险因素;baPWV、CIMT值明显增高(P＜0.05),而ABI指数和颈动脉粥样斑块发生率无明显变化(P＞0.05).以baPWV、CIMT为因变量行多元回归分析示:收缩压(β=0.226,P=0.007)、空腹血糖(β=0.209,P=0.018)、年龄(β=0.279,P=0.002)是baPWV的影响因素;收缩压(β =0.118,P=0.015)、体质量指数(β=0.109,P =0.001)、年龄(β=0.396,P=0.001)是CIMT的影响因素.结论体质量指数、甘油三酯、空腹血糖为正常高值血压的独立危险因素.正常高值血压人群已存在动脉硬化的早期亚临床损害,收缩压水平与baPWV、CIMT均密切相关.
목적 탐토정상고치혈압적위험인소급혈압여동맥경화적상관성.방법 대2011년6월지2012년6월재본원종합의료과입원체검인군456례진행횡단면분석,기중이상혈압조174례、정상고치혈압조282례,포괄인구학특정、혈압、혈액생화대사지표、비과맥박파전도속도(baPWV)、과비지수(ABI)급경동맥내막중층후도(CIMT)등.결과 여이상혈압조상비,정상고치혈압조수축압、서장압、맥압、체질량지수、공복혈당、당화혈홍단백、감유삼지、뇨산、C반응단백수평명현승고(P＜0.05),이고밀도지단백명현강저(P＜0.05);체질량지수(OR=1.185)、감유삼지(OR =1.302)、공복혈당(OR=1.690)위정상고치혈압적독립위험인소;baPWV、CIMT치명현증고(P＜0.05),이ABI지수화경동맥죽양반괴발생솔무명현변화(P＞0.05).이baPWV、CIMT위인변량행다원회귀분석시:수축압(β=0.226,P=0.007)、공복혈당(β=0.209,P=0.018)、년령(β=0.279,P=0.002)시baPWV적영향인소;수축압(β =0.118,P=0.015)、체질량지수(β=0.109,P =0.001)、년령(β=0.396,P=0.001)시CIMT적영향인소.결론 체질량지수、감유삼지、공복혈당위정상고치혈압적독립위험인소.정상고치혈압인군이존재동맥경화적조기아림상손해,수축압수평여baPWV、CIMT균밀절상관.
Objective To explore the risk factors of prehypertension and the relationship between blood pressure and atherosclerosis.Methods The data of 456 cases in the Department of General Medicine were cross-sectional analyzed,including 174 subjects with normotension and 282 with prehypertension.The information was consisted of demographic characteristics,blood pressure,blood biochemical metabolism index,brachia-ankle pulse wave velocity (baPWV),ankle-brachial index (ABI) and carotid intima media thickness (CIMT).Results Compared to normotension group,the levels of systolic pressure,diastolic pressure,pulse pressure,body mass index,fasting blood glucose,glycosylated hemoglobin,triglyceride,uric acid,and C-reactive protein in prehypertension group were significantly increased (P ＜ 0.05) ; and high-density lipoprotein cholesterol was significantly decreased (P ＜0.05) ; the body mass index(OR =1.185),triglyceride(OR =1.302),and fasting blood sugar (OR =1.690) were the independent risk factors of prehypertension ; baPWV and CIMT in prehypertension group were higher,but ABI and artery atheromatous plaque rate were not obvious changed.When baPWV or CIMT were set as the dependent variables,multiple linear regression analysis showed that systolic blood pressure(β =0.226,P =0.007),fasting blood glucose(β =0.209,P =0.018),and age(β =0.279,P =0.002) were risk factors of baPWV;systolic blood pressure(β =0.118,P =0.015),body mass index(β =0.109,P =0.001),and age(β =0.396,P =0.001) were risk factors of CIMT.Conclusions Body mass index,triglycerides,and fasting blood sugar were the independent risk factors of prehypertension.The early subclinical damage of hardening of the arteries was occurred in the prehypertension cases,and systolic blood pressure was closely related with baPWV or CIMT.