原發(fā)性高血壓患者紅細胞分布寬度與Framingham心血管評分風險等級的關系
發(fā)布時間：2019-04-23 08:05
【摘要】：目的高血壓病以進行性動脈血壓持續(xù)升高為臨床特征,可引起心、腦、腎、眼等重要靶器官損害。近年來,多項臨床研究發(fā)現(xiàn)紅細胞分布寬度(RDW)與急性冠狀動脈綜合征(ACS)、心力衰竭(HF)、心房顫動(AF)、腎小球濾過率(GFR)、肺動脈高壓等關系密切,而其與原發(fā)性高血壓患者心血管風險的關系研究甚少。本研究旨在探討原發(fā)性高血壓患者RDW與Framingham心血管危險評分風險等級的相關性。方法入選2014年9月至2016年8月在鄭州大學第二附屬醫(yī)院心內科門診及住院收治的原發(fā)性高血壓患者383例,按Framingham心血管危險評分劃分的風險等級將其分為低危組(n=176)、中危組(n=121)和高危組(n=86),另設正常血壓對照組80例,檢測所有患者血脂、肝腎功能、空腹血糖、RDW、高敏C反應蛋白(hs-CRP)及左心室射血分數(shù)(LVEF)值,測量身高、體質量、血壓,并計算體質量指數(shù)(BMI)。應用有序多分類Logistic回歸分析RDW與Framingham評分風險等級的關系,采用受試者工作特征(ROC)曲線評價RDW對心血管高危人群的判斷價值。結果4組研究對象性別構成、丙氨酸氨基轉移酶(ALT)、總膽固醇、三酰甘油、高密度脂蛋白膽固醇(HDL-C)、血肌酐、空腹血糖、LVEF值等指標比較,差異無統(tǒng)計學意義(均P0.05)。4組患者年齡、BMI、吸煙、糖尿病、服用他汀情況、收縮壓、舒張壓、低密度脂蛋白膽固醇(LDL-C)、胱抑素C(Cys-C)、RDW、hs-CRP等指標比較,差異有統(tǒng)計學意義(均P0.05)。4組RDW比較,高危組高于中危組[(13.42±0.92)%比(12.96±0.50)%],高危組、中危組高于低危組[(12.83±0.51)%]和對照組[(12.69±0.66)%](均P0.05)。Pearson相關分析顯示RDW與LDL-C(r=-0.105)呈負相關,與年齡、Cys-C、hs-CRP、Framingham心血管風險呈正相關(分別r=0.182,0.151,0.566,0.312,均P0.05)。有序多分類Logistic回歸分析結果顯示,在校正了年齡、BMI、吸煙、糖尿病、服用他汀情況、收縮壓、舒張壓、LDL-C、Cys-C、hs-CRP等因素后,RDW仍是Framingham心血管評分風險等級的獨立危險因素(OR=5.601,95%CI:1.557-20.146,P0.05)。ROC曲線分析示RDW 12.95%是預測心血管高危人群的最佳截斷點,其靈敏度為75.6%,特異度為63.9%,ROC曲線下面積為0.735(95%CI:0.676-0.793,P0.001)。結論1.原發(fā)性高血壓患者RDW明顯高于血壓正常人群。2.高RDW(12.95%)水平是心血管高危人群的一個獨立預測指標。3.原發(fā)性高血壓患者RDW可能與心血管風險等級相關。
[Abstract]:Objective Hypertension is characterized by continuous elevation of arterial blood pressure, which can cause damage to heart, brain, kidney, eye and other important target organs. In recent years, many clinical studies have found that red blood cell distribution width (RDW) is closely related to (AF), glomerular filtration rate (AF),) and pulmonary hypertension (GFR),) in patients with acute coronary syndrome (ACS),) heart failure (HF),) and atrial fibrillation (HF),). However, there is little research on the relationship between it and cardiovascular risk in patients with essential hypertension. The purpose of this study was to investigate the correlation between RDW and risk grade of Framingham cardiovascular risk score in patients with essential hypertension. Methods from September 2014 to August 2016, 383 patients with essential hypertension were enrolled in the Department of Cardiology, the second affiliated Hospital of Zhengzhou University. They were divided into low-risk group (n = 176) according to the risk grade of Framingham cardiovascular risk score. The blood lipid, liver and kidney function, fasting blood glucose, RDW,-Gao Min C-reactive protein (hs-CRP) and left ventricular ejection fraction (LVEF) were measured in 80 normal blood pressure control group (n = 80) and middle risk group (n = 121) and high risk group (n = 86). Body mass, blood pressure, and body mass index (BMI). The relationship between RDW and risk grade of Framingham score was analyzed by ordered multi-classification Logistic regression, and the diagnostic value of RDW to cardiovascular high-risk population was evaluated by using the (ROC) curve of receiver operating characteristics. Results the sex composition, alanine aminotransferase (ALT),) total cholesterol, triacylglycerol, high density lipoprotein cholesterol (HDL-C), serum creatinine, fasting blood glucose and LVEF were compared among the four groups. There was no significant difference in age, BMI, smoking, diabetes mellitus, statins use, systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), cystatin C (Cys-C), RDW,), systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein cholesterol (LDL-C). Hs-CRP and other indexes were significantly higher in the high-risk group than in the middle-risk group [(13.42 鹵0.92)% vs (12.96 鹵0.50)%], in the high-risk group [(13.42 鹵0.92)% vs (12.96 鹵0.50)%], in the high-risk group, and in the high-risk group. The median risk group was higher than the low risk group [(12.83 鹵0.51)%] and the control group [(12.69 鹵0.66)%] (all P0.05). Pearson correlation analysis showed that RDW was negatively correlated with LDL-C (r = 0.105), but negatively correlated with age and Cys-C,hs-CRP,. The cardiovascular risk of Framingham was positively correlated (r = 0.182, 0.151, 0.566, 0.312, P 0.05). Ordered multi-classification Logistic regression analysis showed that after adjusting for age, BMI, smoking, diabetes, statins use, systolic blood pressure, diastolic blood pressure, LDL-C,Cys-C,hs-CRP, and other factors, such as age, smoking, diabetes, statins, systolic pressure, diastolic blood pressure, and so on, RDW is still an independent risk factor (OR=5.601,95%CI:1.557-20.146,P0.05) for Framingham cardiovascular risk rating. Roc curve analysis shows that RDW 12.95% is the best cut-off point for predicting cardiovascular risk groups. The sensitivity and specificity were 75.6% and 63.9%, respectively. The area under the curve was 0.735 (95% CI / 0.676 / 0.793, P0.001). Conclusion 1. RDW in patients with essential hypertension was significantly higher than that in normotensive subjects. 2. High RDW (12.95%) is an independent predictor of cardiovascular risk. 3. RDW may be associated with cardiovascular risk levels in patients with essential hypertension.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.11
本文編號：2463276
[Abstract]:Objective Hypertension is characterized by continuous elevation of arterial blood pressure, which can cause damage to heart, brain, kidney, eye and other important target organs. In recent years, many clinical studies have found that red blood cell distribution width (RDW) is closely related to (AF), glomerular filtration rate (AF),) and pulmonary hypertension (GFR),) in patients with acute coronary syndrome (ACS),) heart failure (HF),) and atrial fibrillation (HF),). However, there is little research on the relationship between it and cardiovascular risk in patients with essential hypertension. The purpose of this study was to investigate the correlation between RDW and risk grade of Framingham cardiovascular risk score in patients with essential hypertension. Methods from September 2014 to August 2016, 383 patients with essential hypertension were enrolled in the Department of Cardiology, the second affiliated Hospital of Zhengzhou University. They were divided into low-risk group (n = 176) according to the risk grade of Framingham cardiovascular risk score. The blood lipid, liver and kidney function, fasting blood glucose, RDW,-Gao Min C-reactive protein (hs-CRP) and left ventricular ejection fraction (LVEF) were measured in 80 normal blood pressure control group (n = 80) and middle risk group (n = 121) and high risk group (n = 86). Body mass, blood pressure, and body mass index (BMI). The relationship between RDW and risk grade of Framingham score was analyzed by ordered multi-classification Logistic regression, and the diagnostic value of RDW to cardiovascular high-risk population was evaluated by using the (ROC) curve of receiver operating characteristics. Results the sex composition, alanine aminotransferase (ALT),) total cholesterol, triacylglycerol, high density lipoprotein cholesterol (HDL-C), serum creatinine, fasting blood glucose and LVEF were compared among the four groups. There was no significant difference in age, BMI, smoking, diabetes mellitus, statins use, systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), cystatin C (Cys-C), RDW,), systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein cholesterol (LDL-C). Hs-CRP and other indexes were significantly higher in the high-risk group than in the middle-risk group [(13.42 鹵0.92)% vs (12.96 鹵0.50)%], in the high-risk group [(13.42 鹵0.92)% vs (12.96 鹵0.50)%], in the high-risk group, and in the high-risk group. The median risk group was higher than the low risk group [(12.83 鹵0.51)%] and the control group [(12.69 鹵0.66)%] (all P0.05). Pearson correlation analysis showed that RDW was negatively correlated with LDL-C (r = 0.105), but negatively correlated with age and Cys-C,hs-CRP,. The cardiovascular risk of Framingham was positively correlated (r = 0.182, 0.151, 0.566, 0.312, P 0.05). Ordered multi-classification Logistic regression analysis showed that after adjusting for age, BMI, smoking, diabetes, statins use, systolic blood pressure, diastolic blood pressure, LDL-C,Cys-C,hs-CRP, and other factors, such as age, smoking, diabetes, statins, systolic pressure, diastolic blood pressure, and so on, RDW is still an independent risk factor (OR=5.601,95%CI:1.557-20.146,P0.05) for Framingham cardiovascular risk rating. Roc curve analysis shows that RDW 12.95% is the best cut-off point for predicting cardiovascular risk groups. The sensitivity and specificity were 75.6% and 63.9%, respectively. The area under the curve was 0.735 (95% CI / 0.676 / 0.793, P0.001). Conclusion 1. RDW in patients with essential hypertension was significantly higher than that in normotensive subjects. 2. High RDW (12.95%) is an independent predictor of cardiovascular risk. 3. RDW may be associated with cardiovascular risk levels in patients with essential hypertension.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.11
【參考文獻】
相關期刊論文 前10條
1 李潔;謝晶;姜懋;黃娟娟;楊天倫;;阻塞性呼吸睡眠暫停綜合征與高血壓的研究進展[J];中南大學學報(醫(yī)學版);2016年02期
2 謝蒂立;程標;盛勇;金靜;;急性ST段抬高型心肌梗死患者紅細胞分布寬度與心血管事件的相關性研究[J];醫(yī)學研究生學報;2015年12期
3 周韻;李東澤;羅俊一;吳婷婷;楊毅寧;馬依彤;李曉梅;;紅細胞分布寬度對急性冠狀動脈綜合征患者預后預測價值的Meta分析[J];中國循環(huán)雜志;2015年11期
4 顏凡輝;姜文錫;;心理壓力參與高血壓病形成的機制及研究進展[J];中國循環(huán)雜志;2015年01期
5 張達;王虹艷;曲鵬;;RDW與急性冠脈綜合征冠脈病變嚴重程度及遠期預后相關性的臨床研究[J];臨床心血管病雜志;2015年01期
6 孫佳藝;巢寶華;徐新娟;劉瑩;姚桂華;薛莉;周憲梁;周子華;朱建華;霍勇;;中國三甲醫(yī)院高血壓患者腦卒中十年發(fā)病風險的流行病學研究[J];中華高血壓雜志;2014年10期
7 李震南;柳志紅;顧晴;倪新海;程顯聲;何建國;熊長明;;紅細胞分布寬度與特發(fā)性肺動脈高壓病情和預后的相關性分析[J];中國循環(huán)雜志;2013年02期
8 翟鳳燕;;高血壓與多種危險因素相關性分析[J];中國現(xiàn)代醫(yī)學雜志;2012年15期
9 朱鼎良;;遺傳因素在原發(fā)性高血壓發(fā)病中的新進展[J];中國循環(huán)雜志;2012年02期
10 劉力生;;中國高血壓防治指南2010[J];中華高血壓雜志;2011年08期
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