实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
5期
1-4
,共4页
张清云%周芸玲%胡伟%胡立禄%邹兰%肖莲%罗卉
張清雲%週蕓玲%鬍偉%鬍立祿%鄒蘭%肖蓮%囉卉
장청운%주예령%호위%호립록%추란%초련%라훼
舒张期高血压%心肌梗死%脑梗死%脑出血
舒張期高血壓%心肌梗死%腦梗死%腦齣血
서장기고혈압%심기경사%뇌경사%뇌출혈
Isolated diastolic hypertension%Myocardial infarction%Brain infarction%Cerebral hemorrhage
目的：探讨单纯舒张期高血压（ IDH）对新发心脑血管事件的影响。方法选取2009年2月—2014年2月在广元市第二人民医院、广元市第三人民医院、成都416医院体检中心体检的3850例既往无心脑血管病史的IDH患者作为IDH组，另选取同期在三家医院体检的3000例血压正常者作为对照组。对患者随访12～70个月，随访截止至2015-02-28。收集并记录患者的一般资料〔性别、年龄、体质指数（ BIM）、吸烟、饮酒、喜盐、锻炼、收缩压（SBP）、舒张压（DBP）、心率（HR）〕、生化指标〔总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（ HDL）、空腹血糖（ FPG）〕及心肌梗死、脑梗死、脑出血及总心脑血管事件的发生情况。采用Cox回归模型分析IDH对心脑血管事件的影响。结果两组受试者年龄、HDL、FPG比较，差异无统计学意义（ P>0.05）；IDH组患者男性比例、BMI、吸烟率、饮酒率、喜盐率、SBP、DBP、HR、TC、TG、LDL均高于对照组，锻炼率低于对照组（P<0.05）。IDH组患者脑梗死、脑出血及总心脑血管事件发生率（1.10%、0.52%、1.93%）高于对照组（0.50%、0.10%、0.80%）（P<0.05）；两组受试者心肌梗死发生率（对照组及IDH组分别为0.31%与0.30%）比较，差异无统计学意义（P>0.05）。IDH组患者脑梗死、脑出血及总心脑血管事件的发生风险分别是对照组的2.52倍〔RR=2.52，95%CI（1.32，5.04）〕、1.54倍〔RR =1.54，95%CI（1.14，2.58）〕、1.51倍〔RR =1.51，95%CI （1.20，2.63）〕；<60岁的IDH患者脑梗死、脑出血及总心脑血管事件的发生风险分别是对照组的1.49倍〔RR=1.49，95%CI（1.21，2.76）〕、1.32倍〔RR=1.32，95%CI（1.13，2.76）〕、1.18倍〔RR =1.18，95%CI（1.04，3.24）〕；≥60岁的IDH患者的脑梗死、脑出血及总心脑血管事件的发生风险分别是对照组的2.98倍〔RR =2.98，95%CI（1.64，4.95）〕、4.32倍〔RR =4.32，95% CI（2.76，7.33）〕、1.90倍〔RR =1.90，95% CI（1.27，4.37）〕。结论 IDH是心脑血管事件的危险因素，高龄IDH患者发生心脑血管事件的风险较高，临床应引起重视。
目的：探討單純舒張期高血壓（ IDH）對新髮心腦血管事件的影響。方法選取2009年2月—2014年2月在廣元市第二人民醫院、廣元市第三人民醫院、成都416醫院體檢中心體檢的3850例既往無心腦血管病史的IDH患者作為IDH組，另選取同期在三傢醫院體檢的3000例血壓正常者作為對照組。對患者隨訪12～70箇月，隨訪截止至2015-02-28。收集併記錄患者的一般資料〔性彆、年齡、體質指數（ BIM）、吸煙、飲酒、喜鹽、鍛煉、收縮壓（SBP）、舒張壓（DBP）、心率（HR）〕、生化指標〔總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（ HDL）、空腹血糖（ FPG）〕及心肌梗死、腦梗死、腦齣血及總心腦血管事件的髮生情況。採用Cox迴歸模型分析IDH對心腦血管事件的影響。結果兩組受試者年齡、HDL、FPG比較，差異無統計學意義（ P>0.05）；IDH組患者男性比例、BMI、吸煙率、飲酒率、喜鹽率、SBP、DBP、HR、TC、TG、LDL均高于對照組，鍛煉率低于對照組（P<0.05）。IDH組患者腦梗死、腦齣血及總心腦血管事件髮生率（1.10%、0.52%、1.93%）高于對照組（0.50%、0.10%、0.80%）（P<0.05）；兩組受試者心肌梗死髮生率（對照組及IDH組分彆為0.31%與0.30%）比較，差異無統計學意義（P>0.05）。IDH組患者腦梗死、腦齣血及總心腦血管事件的髮生風險分彆是對照組的2.52倍〔RR=2.52，95%CI（1.32，5.04）〕、1.54倍〔RR =1.54，95%CI（1.14，2.58）〕、1.51倍〔RR =1.51，95%CI （1.20，2.63）〕；<60歲的IDH患者腦梗死、腦齣血及總心腦血管事件的髮生風險分彆是對照組的1.49倍〔RR=1.49，95%CI（1.21，2.76）〕、1.32倍〔RR=1.32，95%CI（1.13，2.76）〕、1.18倍〔RR =1.18，95%CI（1.04，3.24）〕；≥60歲的IDH患者的腦梗死、腦齣血及總心腦血管事件的髮生風險分彆是對照組的2.98倍〔RR =2.98，95%CI（1.64，4.95）〕、4.32倍〔RR =4.32，95% CI（2.76，7.33）〕、1.90倍〔RR =1.90，95% CI（1.27，4.37）〕。結論 IDH是心腦血管事件的危險因素，高齡IDH患者髮生心腦血管事件的風險較高，臨床應引起重視。
목적：탐토단순서장기고혈압（ IDH）대신발심뇌혈관사건적영향。방법선취2009년2월—2014년2월재엄원시제이인민의원、엄원시제삼인민의원、성도416의원체검중심체검적3850례기왕무심뇌혈관병사적IDH환자작위IDH조，령선취동기재삼가의원체검적3000례혈압정상자작위대조조。대환자수방12～70개월，수방절지지2015-02-28。수집병기록환자적일반자료〔성별、년령、체질지수（ BIM）、흡연、음주、희염、단련、수축압（SBP）、서장압（DBP）、심솔（HR）〕、생화지표〔총담고순（TC）、삼선감유（TG）、저밀도지단백（LDL）、고밀도지단백（ HDL）、공복혈당（ FPG）〕급심기경사、뇌경사、뇌출혈급총심뇌혈관사건적발생정황。채용Cox회귀모형분석IDH대심뇌혈관사건적영향。결과량조수시자년령、HDL、FPG비교，차이무통계학의의（ P>0.05）；IDH조환자남성비례、BMI、흡연솔、음주솔、희염솔、SBP、DBP、HR、TC、TG、LDL균고우대조조，단련솔저우대조조（P<0.05）。IDH조환자뇌경사、뇌출혈급총심뇌혈관사건발생솔（1.10%、0.52%、1.93%）고우대조조（0.50%、0.10%、0.80%）（P<0.05）；량조수시자심기경사발생솔（대조조급IDH조분별위0.31%여0.30%）비교，차이무통계학의의（P>0.05）。IDH조환자뇌경사、뇌출혈급총심뇌혈관사건적발생풍험분별시대조조적2.52배〔RR=2.52，95%CI（1.32，5.04）〕、1.54배〔RR =1.54，95%CI（1.14，2.58）〕、1.51배〔RR =1.51，95%CI （1.20，2.63）〕；<60세적IDH환자뇌경사、뇌출혈급총심뇌혈관사건적발생풍험분별시대조조적1.49배〔RR=1.49，95%CI（1.21，2.76）〕、1.32배〔RR=1.32，95%CI（1.13，2.76）〕、1.18배〔RR =1.18，95%CI（1.04，3.24）〕；≥60세적IDH환자적뇌경사、뇌출혈급총심뇌혈관사건적발생풍험분별시대조조적2.98배〔RR =2.98，95%CI（1.64，4.95）〕、4.32배〔RR =4.32，95% CI（2.76，7.33）〕、1.90배〔RR =1.90，95% CI（1.27，4.37）〕。결론 IDH시심뇌혈관사건적위험인소，고령IDH환자발생심뇌혈관사건적풍험교고，림상응인기중시。
Objective To investigate the impact of isolated diastolic hypertension on cardio-cerebrovascular events. Methods From February 2009 to February 2014 in the Second People's Hospital of Guangyuan,the Third People's Hospital of Guangyuan and the 416th Hospital of Chengdu,3 850 isolated diastolic hypertension patients without cardio -cerebrovascular disease history were selected as case group, and 3 000 healthy cases with normal blood pressure were selected as control group. All of the cases were followed up for 12 to 70 months,the deadline of follow-up was 2015-02-28. General information including gender,age,BMI,SBP,DBP,HR and smoking rate,drinking rate,high -salt diet rate,exercise frequency, biochemical index including TC, TG, LDL, HDL, FPG, incidence of myocardial infarction, cerebral infarction, cerebral hemorrhage and total cardio - cerebrovascular events were recorded. Cox regression model was used to analyze the impact of isolated diastolic hypertension on cardio-cerebrovascular events. Results No statistically significant differences of age,HDL or FPG was found between the two groups(P>0. 05);The proportion of male,BMI,smoking rate,drinking rate,high-salt diet rate,SBP,DBP,HR,TC,TG,LDL of case group were statistically significantly higher than those of control group, while exercise frequency of case group was statistically significantly lower than that of control group(P<0. 05). The incidence of cerebral infarction,cerebral hemorrhage and total cardio-cerebrovascular events of case group(1. 10%,0. 52%,1. 93%, respectively)was statistically significantly higher than that of control group(0. 50%,0. 10%,0. 80%,respectively)(P<0. 05);while no statistically significant differences of incidence of myocardial infarction was found between the two group (0. 31% versus 0. 30%,P > 0. 05). The occurrence risk of cerebral infarction,cerebral hemorrhage and total cardio -cerebrovascular events of case group was 2. 52 times〔RR=2. 52,95%CI(1. 32,5. 04)〕,1. 54 times〔RR=1. 54,95%CI (1. 14,2. 58)〕,1. 51 times〔RR =1. 51,95%CI(1. 20,2. 63)〕of control group,respectively;the occurrence risk of cerebral infarction,cerebral hemorrhage and total cardio -cerebrovascular events of patients<60 years old in case group was 1. 49 times〔RR=1. 49,95%CI(1. 21,2. 76)〕,1. 32 times〔RR=1. 32,95%CI(1. 13,2. 76)〕,1. 18 times〔RR=1. 18,95%CI(1. 04,3. 24)〕of control group,respectively,while that of patients≥60 years old in case group was 2. 98 times〔RR=2. 98,95%CI(1. 64,4. 95)〕,4. 32 times〔RR=4. 32,95%CI(2. 76,7. 33)〕,1. 90 times〔RR=1. 90, 95%CI(1. 27,4. 37)〕of control group,respectively. Conclusion Isolated diastolic hypertension is one of risk factors of cardio- cerebrovascular events,and the occurrence risk of aged isolated diastolic hypertension patients is relatively higher, which should be pay more attention to.
