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目的了解新疆汉族、维吾尔族、哈萨克族原发性高血压患者发生左心室重构(LR)的相关影响因素及可能存在的民族差异。方法连续收集2013年1月至2015年1月新疆医科大学第一附属医院高血压科收治的确诊原发性高血压患者,根据民族分为汉、维吾尔、哈萨克族3组,再以有无LR分为2个亚组,比较各组原发性高血压患者动态血压参数、LR构型的差异,分析原发性高血压患者发生LR的危险因素。结果共收集原发性高血压患者1481例,其中368例发生LR(发生率为24.85%),男性218例(发生率为27.05%),女性150例(发生率为22.22%),男性患者LR发生率高于女性患者(χ~2=4.580,P<0.05)。汉族、维吾尔族、哈萨克族原发性高血压患者LR发生率分别为18.55%、35.07%和27.59%,各民族间LR发生率的差异有统计学意义(χ~2=41.636,P<0.01)。原发性高血压患者LR中以向心性重构(CR)最常见(17.76%),其次为向心性肥厚(CH)(5.00%),而离心性肥厚(EH)的发生率最低(2.09%),差异有统计学意义(χ~2=46.787,P<0.01)。Logistic回归分析表明,不同民族原发性高血压患者发生LR的风险不同,与汉族人群相比较,维吾尔族原发性高血压患者发生LR的风险增加了1.192倍(OR2.192,95%CI1.440~3.336),哈萨克族原发性高血压患者发生LR的风险增加了0.660倍(OR1.660,95%CI1.005~2.741)。不同民族发生LR的危险因素不同,汉族为24h平均收缩压(24hSBP)及颈动脉斑块;维吾尔族为24hSBP及心律失常;而哈萨克族为白天平均舒张压(dDBP)。结论新疆原发性高血压患者发生LR存在民族及性别差异,不同民族LR的危险因素不同。
Objective To understand the related factors of left ventricular remodeling (LR) and possible ethnic differences in Han, Uygur and Kazak patients with essential hypertension in Xinjiang. Methods The patients with confirmed essential hypertension who were admitted to Department of Hypertension, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to January 2015 were enrolled and divided into three groups according to ethnicity: Han, Uyghur and Kazak, and then with or without LR Divided into two subgroups, comparing the differences of ambulatory blood pressure parameters and LR configurations in patients with essential hypertension, and analyzed the risk factors of LR in patients with essential hypertension. Results A total of 1481 patients with essential hypertension were enrolled. Among them, 368 patients had LR (incidence 24.85%), 218 males (27.05%) and 150 females (incidence 22.22%). Male patients with LR The incidence was higher in female patients (χ ~ 2 = 4.580, P <0.05). The incidence of LR was 18.55%, 35.07% and 27.59% in Han, Uygur and Kazak patients, respectively. The incidence of LR among different ethnic groups was statistically significant (χ ~ 2 = 41.636, P <0.01) . In patients with essential hypertension, the centripetal remodeling (CR) was the most common in LR (17.76%), followed by concentric hypertrophy (CH) (5.00%), while the incidence of eccentric hypertrophy (EH) was the lowest ), The difference was statistically significant (χ ~ 2 = 46.787, P <0.01). Logistic regression analysis showed that patients with essential hypertension in different ethnic groups had different risk of developing LR. Compared with Han nationality, the risk of LR in Uygur patients with essential hypertension increased 1.192-fold (OR2.192,95% CI1). 440 ~ 3.336). The risk of developing LR in Kazakh patients with essential hypertension increased 0.660-fold (OR1.660, 95% CI 1.005-2.741). Different nationalities have different risk factors for LR. The mean systolic blood pressure (24hSBP) and carotid artery plaque in Han nationality are 24 hSBP and arrhythmia in Uyghur nationality, mean day-time mean diastolic blood pressure (dDBP) in Kazak nationality. Conclusion There are ethnic and gender differences in the occurrence of LR in patients with essential hypertension in Xinjiang, and the risk factors of LR in different ethnic groups are different.