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目的探讨原发性高血压患者红细胞分布宽度(RDW)与左心室肥厚(LVH)之间的关系。方法入选首都医科大学宣武医院心脏科门诊新发未经治疗的原发性高血压患者500例作为研究对象,所有患者均检测生化指标及血常规指标,行超声心动图检查并计算左室心肌质量指数(LVMI)。根据LVMI将患者分为高血压合并LVH组(n=210)和高血压无LVH组(n=290),分析RDW与高血压患者LVH的相关性。结果与高血压无LVH组比较,高血压合并LVH组的RDW水平明显升高[(13.17±0.67)%vs(12.70±0.64)%]差异有统计学意义(P<0.05)。相关性分析显示,RDW水平与LVMI呈正性相关(r=0.542,P<0.05)。Logistic回归分析显示,在校正了收缩压、空腹血糖、血尿酸及估算肾小球滤过率等因素后,RDW仍是高血压伴左心室肥厚的独立危险因素(OR=2.717,95%CI 1.949-3.787,P<0.05)。结论与无左心室肥厚的高血压患者比较,高血压伴左心室肥厚患者RDW水平明显升高;RDW升高可能是高血压患者左心室肥厚的独立危险因素。
Objective To investigate the relationship between the distribution width of red blood cells (RDW) and left ventricular hypertrophy (LVH) in patients with essential hypertension. Methods One hundred and fifty cases of newly diagnosed untreated essential hypertension in the Department of Cardiology, Xuanwu Hospital, Capital Medical University were enrolled in this study. All patients were tested for biochemical and blood parameters, echocardiography and left ventricular mass Index (LVMI). According to LVMI, patients were divided into two groups: hypertensive patients with LVH (n = 210) and patients without hypertension (n = 290). The correlation between RDW and LVH was analyzed. Results Compared with hypertension without LVH, RDW in hypertensive patients with LVH was significantly higher than that without LVH [(13.17 ± 0.67)% vs (12.70 ± 0.64)%] (P <0.05). Correlation analysis showed that RDW was positively correlated with LVMI (r = 0.542, P <0.05). Logistic regression analysis showed that RDW was still an independent risk factor of hypertension with left ventricular hypertrophy after adjusting for systolic blood pressure, fasting blood glucose, serum uric acid and estimated glomerular filtration rate (OR = 2.717, 95% CI 1.949 -3.787, P <0.05). Conclusions Compared with hypertensive patients without left ventricular hypertrophy, RDW levels in hypertensive patients with left ventricular hypertrophy were significantly increased. Elevated RDW may be an independent risk factor for left ventricular hypertrophy in hypertensive patients.