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目的探讨杭州城乡居民血铅、镉与原发性高血压发病的关系。方法随机抽取杭州城区与农村社区各一个,对40岁以上长住户籍共进行471人问卷调查与健康体检,检测血铅、镉、空腹血糖、血脂等指标。两组间计量资料比较采用t检验,多组比较采用方差分析、组间比较采用LSD检验,多因素相关分析采用logistic回归分析,P<0.05为差异有统计学意义。结果获得完整资料共453人,其中城区266人中有高血压128人,血压正常138人;乡村187人中有高血压84人,血压正常103人。血铅、镉测值在城乡高血压两组间及血压正常两组间差异均无统计学意义,但城乡高血压组均明显高于城乡血压正常组(P<0.05,P<0.01);总胆固醇测值城区高血压组明显高于乡村高血压组和城乡血压正常组(P<0.05,P<0.01),乡村高血压组明显高于乡村血压正常组(P<0.05);甘油三酯测值城区高血压组和血压正常组均明显高于乡村血压正常组(P<0.05,P<0.01);空腹血糖测值城区高血压组明显高于乡村血压正常组(P<0.05)。多因素logistic回归分析显示年龄、血铅、镉和总胆固醇与高血压发病有密切关系(R=1.04～1.58,P均<0.01)。结论血铅、镉是原发性高血压的危险因素之一,在高血压的发生发展中起着一定作用。
Objective To investigate the relationship between blood lead, cadmium and essential hypertension in Hangzhou urban and rural residents. Methods A total of 471 permanent residents aged 40 and over were surveyed by questionnaire and physical examination in Hangzhou city and rural community respectively. Blood lead, cadmium, fasting blood glucose and blood lipid were measured. The t test was used to compare the measurement data between two groups. The variance analysis was used to compare multiple groups. LSD test was used to compare the two groups. Logistic regression analysis was used to analyze the multiple factors. P <0.05 was considered as significant difference. The results obtained a total of 453 people, including 266 urban residents with hypertension in 128 people, normal blood pressure 138; rural 187 people with hypertension in 84 people, normal blood pressure 103 people. Blood lead and cadmium measured in urban and rural areas between the two groups of hypertension and normal blood pressure was no significant difference between the two groups, but the urban-rural hypertension group were significantly higher than the urban-rural blood pressure group (P <0.05, P <0.01); Cholesterol measurement in urban hypertension group was significantly higher than that in rural hypertension group and urban-rural normal blood pressure group (P <0.05, P <0.01), rural hypertension group was significantly higher than rural normal blood pressure group (P <0.05) In the urban hypertension group and the normal blood pressure group were significantly higher than those in the rural normal blood pressure group (P <0.05, P <0.01). The fasting blood glucose was significantly higher in the urban hypertension group than in the rural normal blood pressure group (P <0.05). Multivariate logistic regression analysis showed that age, blood lead, cadmium and total cholesterol were closely related to the incidence of hypertension (R = 1.04-1.58, P <0.01). Conclusion Blood lead and cadmium are one of the risk factors of essential hypertension and play a role in the occurrence and development of hypertension.