本文關(guān)鍵詞：高血壓前期合并肥胖患者左心室結(jié)構(gòu)及功能變化與高敏C反應(yīng)蛋白的相關(guān)性研究　出處：《山西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 高血壓前期 肥胖 左室質(zhì)量數(shù) 室壁中層縮短率 高敏C反應(yīng)蛋白

【摘要】：目的:通過觀測高血壓前期合并肥胖患者左心室結(jié)構(gòu)與功能、高敏C反應(yīng)蛋白水平變化趨勢,探討高血壓前期、肥胖患者左心室結(jié)構(gòu)及功能變化機制,并研究其與高敏C反應(yīng)蛋白的關(guān)系。方法:選取我院2013年6月至2014年12月住院部及體檢中心35-68歲人群,按分組標準分為4組,包括高血壓前期組(PG)81例,肥胖組(OG)75例,高血壓前期合并肥胖組(POG)60例,同時選擇45例同時期在我院體檢中心進行健康體檢且結(jié)果正常的人群作為正常對照組(NG)。所選研究對象均記錄年齡、性別、吸煙、飲酒史等基本資料,計算體重指數(shù)(BMI),隔夜空腹12小時后于次日清晨測量身高體重、血壓水平;檢測包括膽固醇(TC),甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)及空腹血糖(FPG)在內(nèi)的常規(guī)生化指標;采用乳膠免疫增強比濁法測量高敏C反應(yīng)蛋白濃度(hs-CRP)。超聲心動圖測定左室舒張末期內(nèi)徑(LVIDd)、左室收縮末期內(nèi)徑(LVIDs)、室間隔厚度(IVST)、舒張末期室間隔厚度(IVSd)、收縮末期室間隔厚度(IVSs)、左室后壁厚度(LVPWT)、左室舒張末期后壁厚度(PWTd)、左室收縮末期后壁厚度(PWTs)、舒張早期血流峰值流速(E)、舒張晚期血流峰值流速(A),并計算出左室質(zhì)量指數(shù)(LVMI)、室壁中層縮短率(m FS)及舒張早期與舒張晚期充盈速度比值(E/A)。結(jié)果:1.POG組LVMI(53.68±10.29g/m2.7)顯著高于PG組(41.53±9.64g/m2.7)、OG組(39.98±8.92g/m2.7)和NG組(28.46±5.73g/m2.7),且差異均有統(tǒng)計學(xué)意義(P0.05);PG組及OG組LVMI均高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。2.POG組m FS(11.73±3.74%)顯著低于PG組(15.81±4.96%)、OG組(15.16±4.23%)和NG組(19.47±4.94%),且差異均有統(tǒng)計學(xué)意義(P0.05);PG組、OG組均顯著低于NG組,差異均有統(tǒng)計學(xué)意義(P0.05)。E/A值在四組間比較差異均無統(tǒng)計學(xué)意義(P0.05)。3.POG組患者hs-CRP(9.6±0.7mg/L)顯著高于PG組(6.9±0.5mg/L)、OG組(6.2±0.4mg/L)和NG組(4.1±0.3mg/L),且差異均有統(tǒng)計學(xué)意義(P0.05);PG、OG組hs-CRP濃度高于NG組,差異均有統(tǒng)計學(xué)意義(P0.05)。4.析因分析示高血壓前期和肥胖在LVMI、m FS、hs-CRP中均有交互作用。5.LVMI與m FS呈顯著負相關(guān)(r=-0.783,P0.05),與hs-CRP濃度呈顯著正相關(guān)(r=0.694,P0.05),與收縮壓水平呈正相關(guān)(r=0.951,P0.05),與舒張壓水平呈正相關(guān)(r=0.763,P0.05);m FS與收縮壓水平呈負相關(guān)(r=-0.695,P0.05),與舒張壓水平呈負相關(guān)(r=-0.894,P0.05)。6.回歸分析示BMI、SBP、DBP、hs-CRP為影響LVMI的主要因素;BMI、SBP、DBP、hs-CRP為影響m FS的主要因素;僅有收縮壓為影響E/A比值的主要因素。結(jié)論:高血壓前期、肥胖是心血管疾病的危險因素;高血壓前期及肥胖的交互作用可加重心功能損傷。hs-CRP參與了高血壓前期、肥胖患者的心臟靶器官損害。
[Abstract]:Objective: to investigate the mechanism of left ventricular structure and function in prehypertensive and obese patients by observing the changes of left ventricular structure and function and the change trend of Gao Min C-reactive protein level. Methods: from June 2013 to December 2014, the patients aged 35 to 68 years old in our hospital and the physical examination center were divided into 4 groups according to the standard of grouping. There were 81 cases of prostaglandin in prehypertension group, 75 cases of OGN in obese group and 60 cases of POGN in prehypertension combined with obesity group. At the same time, 45 healthy people were selected as the normal control group. All the subjects were recorded the basic data of age, sex, smoking, drinking history and so on. Body mass index (BMI) was calculated. Height, weight and blood pressure were measured early the next morning after fasting for 12 hours. The routine biochemical parameters including TC, TGG, LDL-C, HDL-C and FPG were detected. The concentration of high sensitive C-reactive protein was measured by emulsion immunoenhancement turbidimetry. The left ventricular end-diastolic diameter (LVIDdN) and left ventricular end-systolic diameter (LVIDs) were measured by echocardiography. Interventricular septal thickness (IVSTT), end-diastolic septal thickness (IVSdT), end-systolic septal thickness (LVSsT), left ventricular posterior wall thickness (LVPWT). Left ventricular end diastolic posterior wall thickness, left ventricular end systolic posterior wall thickness, early diastolic peak flow velocity and late diastolic peak flow velocity. Left ventricular mass index (LVMI) was calculated. The ratio of early diastolic to late diastolic filling velocity was E / A. Results 1. LVMI(53.68 鹵10.29 g / m ~ (2.7) in POG group). It was significantly higher than that in PG group (41.53 鹵9.64g / m2.7). 39.98 鹵8.92 g / m ~ (2.7) in group OG and 28.46 鹵5.73 g / m ~ (2.7) in group NG, and the difference was statistically significant (P < 0.05). The LVMI of PG group and OG group were higher than that of control group. The difference was statistically significant. The m FS(11.73 鹵3.74 in POG group was significantly lower than that in PG group (15.81 鹵4.96). In group OG (15.16 鹵4.23) and group NG (19.47 鹵4.94), the difference was statistically significant (P 0.05). Group PG and group OG were significantly lower than those in group NG. All the differences were statistically significant. There was no significant difference between the four groups in the value of P0.05U. EPA. 3. The hs-CRP of POG group was higher than that of the control group (P < 0.05). 9.6 鹵0.7 mg / L) was significantly higher than that in PG group (6.9 鹵0.5 mg / L). OG group (6.2 鹵0.4 mg / L) and NG group (4.1 鹵0.3 mg / L), and the difference was statistically significant (P 0.05). The concentration of hs-CRP in PGN OG group was higher than that in NG group, and the difference was statistically significant (P 0.05). 4. Factorial analysis showed that prehypertension and obesity were in LVMIM FS. There was significant negative correlation between LVMI and MFS in hs-CRP (P 0.05). There was a significant positive correlation with the concentration of hs-CRP, 0.694m P0.05A, and a positive correlation with systolic blood pressure (SBP). There was a positive correlation between diastolic blood pressure and diastolic blood pressure. MFS was negatively correlated with systolic blood pressure (SBP) and diastolic blood pressure (P < 0.05) and diastolic blood pressure (DBP), respectively. Regression analysis showed that BMI was a negative correlation with systolic blood pressure (SBP) level and diastolic blood pressure (DBP) level. DBP hs-CRP was the main factor affecting LVMI. BMIS SBPU DBP hs-CRP was the main factor affecting mFS. Only systolic blood pressure (SBP) was the main factor affecting E / A ratio. Conclusion: before hypertension, obesity is a risk factor of cardiovascular disease. The interaction of prehypertension and obesity can aggravate the damage of cardiac function. Hs-CRP is involved in the heart target organ damage of obese patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R544.1;R589.2

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