發(fā)布時間：2018-06-16 02:38

  本文選題：原發(fā)性高血壓 + 心理壓力��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:采用結(jié)構(gòu)方程模型分析心理壓力對血壓及各生化指標(biāo)作用的直接途徑和間接途徑。方法:選取2015年1月至2017年3月于新疆醫(yī)科大學(xué)第五附屬醫(yī)院門診就診、住院患者及體檢中心健康體檢者的連續(xù)病例,依據(jù)原發(fā)性高血壓的診斷標(biāo)準(zhǔn),將所有滿足本研究研究對象共600人,均完善身高、體重、腹圍、體重指數(shù)、年齡、性別等基本臨床資料,測量血壓和生化指標(biāo),并完善知覺壓力量表。將研究對象分為四組:高壓力高血壓組(HPPH,n=150)、低壓力高血壓組(LPPH,n=150)、高壓力對照組(HPPC,n=150)、低壓力對照組(LPPC,n=150),對各組的基本資料及生化指標(biāo)進行相關(guān)統(tǒng)計學(xué)分析。然后采用SEM方法探討心理壓力對血壓及各生化指標(biāo)影響的直接途徑和間接途徑,認(rèn)為P0.05為差異具有統(tǒng)計學(xué)意義,采用Amos21.0軟件進行結(jié)構(gòu)方程模型統(tǒng)計分析。結(jié)果:1.經(jīng)方差分析結(jié)果提示:HPPH的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于其它三組;LPPH的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于HPPC和LPPC;HPPC的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于LPPC;而HDL-C與之相反,差異均有統(tǒng)計學(xué)意義(P0.05)。2.經(jīng)SEM分析結(jié)果顯示:心理壓力對血壓(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)、AngII、ALD、Hcy影響顯著(P0.05),與血壓(SBP,DBP)、血脂(TC,TG,LDL-C)、Ang II、ALD、Hcy呈正向關(guān)系(P0.05);與HDL-C呈負(fù)向關(guān)系(P0.05)。AngII對血壓(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)影響顯著(P0.05),與血壓(SBP,DBP),血脂(TC,TG,LDL-C)呈正向關(guān)系(P0.05),與HDL-C呈負(fù)向關(guān)系(P0.05)。ALD對血壓(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)影響顯著(P0.05),與血壓(SBP,DBP),血脂(TC,TG,LDL-C)呈正向關(guān)系(P0.05),與HDL-C呈顯著負(fù)向關(guān)系(P0.05);血壓(SBP,DBP)對血脂(TC,TG,LDL-C,HDL-C)、Hcy影響顯著(P0.05),與TC、TG、LDL-C、Hcy呈正向關(guān)系(P0.05);與HDL-C呈負(fù)向關(guān)系(P0.05)。結(jié)論:1心理壓力使EH患者血壓(SBP、DBP)水平升高,心理壓力越大,血壓水平越高。2心理壓力使EH患者血脂(TC、TG和LDL-C)和Hcy水平升高,而使HDL-C水平降低;心理壓力越大,TC、TG、LDL-C,Hcy水平越高,而HDL-C水平越低。3心理壓力使EH患者AngⅡ和ALD升高,間接導(dǎo)致血壓和血脂水平升高,心理壓力越大,Ang II和ALD水平越高,進而血壓和血脂水平越高。4血壓使血脂(TC、TG和LDL-C)和Hcy水平升高,而使HDL-C水平降低;血壓水平越高,TC、TG、LDL-C,Hcy水平越高,而HDL-C水平越低。
[Abstract]:Aim: to analyze the direct and indirect effects of psychological pressure on blood pressure and biochemical indexes by structural equation model. Methods: from January 2015 to March 2017, consecutive cases were selected from outpatients, inpatients and health examiners in the Fifth affiliated Hospital of Xinjiang Medical University, according to the diagnostic criteria of essential hypertension. All 600 subjects were selected to complete the basic clinical data, such as height, weight, abdominal circumference, body mass index, age and sex, to measure blood pressure and biochemical indexes, and to perfect the perceptual stress scale. The subjects were divided into four groups: high pressure hypertension group, low pressure hypertension group, high pressure control group and low pressure control group. The basic data and biochemical indexes of each group were analyzed statistically. Then the direct and indirect ways of the influence of psychological pressure on blood pressure and biochemical indexes were discussed by using Amos21.0 software. The results showed that P0.05 was statistically significant. The statistical analysis of structural equation model was carried out by using Amos21.0 software. The result is 1: 1. The results of ANOVA showed that the ALD and Hcy of the two groups were higher than those of the other three groups, and the ALD and Hcy of the two groups were higher than those of the HPPC and LPPCHPPC, but the difference of HDL-C and HDL-C was statistically significant (P0.05n.2.The results showed that the ALD and Hcy of the two groups were higher than those of the HPPC and the LPPCHPPC. The results showed that the ALD and Hcy of the two groups were higher than those of the other three groups. The results of SEM analysis showed that psychological stress had a significant effect on blood pressure SBP, TGLDL-C, HDL-LDL-C, and Hcy, and had a positive relationship with blood pressure (SBP), blood lipid (TCG), LDL-C (Ang IIALD) Hcy (P0.05), negative relationship with HDL-C (P 0.05 .AngII), TCG-TGLDL-C (HDL-C), and blood pressure (P < 0.05), blood lipid (TCC) TGLDL-C (HDL-C), blood pressure (P < 0.05), blood lipid (TCC) TGLDL-C (HDL-C), blood lipid (TCC) TGLDL-C (P < 0.05), and TCCT TGLDL-C (P < 0.05), and TCCT TGLDL-C (TGLDL-C) were positively correlated with blood pressure (P < 0.05), and TCC TGLDL-C (TGLDL-C) were positively correlated with blood pressure (P < 0.05). There was a negative relationship between P0.05A and HDL-C. ALD had a significant effect on blood pressure and TGLDL-Con HDL-C0. 05, a positive relationship with blood pressure SBP0. 05, a positive relationship between TGLDL-C0. 05 and HDL-C, and a negative relationship with HDL-C, and a negative relationship between blood pressure SBPDBP0. 05 and TCTGLDL-Ch Hcy, a positive relationship with TCTGLDL-Cy, and a negative relationship of P0. 05 with TCTGLDL-C0. 05. the relationship between Hcy and TCTGLDL-Cy was positive (P0. 05), and a negative correlation was found between TGLDL-HDL-Hcy and TC- TGLDL-Hcy (P0. 05), and a negative relationship between TGLDL-Hcy and TC- TGLDL-Hcy was observed (P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P 0. 05, respectively). Conclusion the higher the psychological stress, the higher the level of TCU TG, LDL-C) and Hcy, but the lower the level of HDL-C, the higher the psychological stress, the higher the level of LDL-Ccy and TG, the higher the level of LDL-Ccy, the higher the psychological stress, the higher the level of LDL-Ccy, and the higher the level of TCG-LDL-Ccy, the higher the level of TCG-LDL-CHcy, the higher the level of TCG-LDL-Ccy. The lower the level of HDL-C was, the lower the psychological stress was, the higher the level of Ang 鈪，

本文編號：2024857