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目的研究代谢综合征(MS)对原发性高血压(EH)亚临床靶器官损害的影响,探讨MS与EH亚临床靶器官损害的相关性。方法 320例原发性高血压患者测定其血压、血脂、血糖等,计算体重指数(BMI)。所有患者接受超声心动图及颈动脉超声检查,计算左室质量指数,区分有无左心室肥厚。测量颈动脉中内膜厚度并测定尿白蛋白浓度。按有无MS分二组,分别以有无左室肥厚、尿微量白蛋白、颈动脉内膜-中膜增厚为因变量,以年龄、性别、血压等为自变量,进行Logistic回归分析,比较不同的代谢因素对应的不同靶器官损害。结果 MS组发生左室肥厚、尿微量白蛋白、颈动脉中内膜增厚或斑块形成的比例明显高于非MS组;多元逐步回归结果表明:腰围是导致左室肥厚的独立危险因素;空腹血糖与尿微量白蛋白独立相关;年龄、腰围是导致颈动脉中-内膜增厚的独立危险因素。结论高血压患者合并代谢综合征时,其亚临床靶器官损害的发生率及严重程度均明显增强;不同的代谢因素对应的靶器官损害亦不同。
Objective To study the effect of metabolic syndrome (MS) on the damage of subclinical target organ in patients with essential hypertension (EH), and to explore the correlation between MS and subclinical target organ damage of EH. Methods 320 patients with essential hypertension were measured blood pressure, blood lipids, blood glucose, body mass index (BMI). All patients underwent echocardiography and carotid ultrasound examination, the calculation of left ventricular mass index, the distinction between the presence or absence of left ventricular hypertrophy. Intima thickness in the carotid artery was measured and urinary albumin concentration was measured. According to the presence or absence of MS, two groups were respectively subjected to Logistic regression analysis with or without left ventricular hypertrophy, urinary albumin, carotid intima-media thickening as dependent variables, age, sex and blood pressure as independent variables, Comparison of different metabolic factors corresponding to different target organ damage. Results The incidence of left ventricular hypertrophy, urinary albumin, intima-media thickness or plaque formation in MS group was significantly higher than that in non-MS group. Multiple regression analysis showed that waist circumference was an independent risk factor for left ventricular hypertrophy. Fasting plasma glucose and urine albumin were independently related to age and waist circumference were the independent risk factors of carotid intima-media thickness. Conclusions The morbidity and severity of subclinical target organ damage were significantly increased in hypertensive patients with metabolic syndrome. Different metabolic factors were also associated with different target organ damage.