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目的探讨高血压患者并发心力衰竭的危险因素。方法回顾性分析115例原发性高血压患者的临床资料,其中发生心力衰竭的52例患者作为心衰组,未发生心力衰竭的63例作为非心衰组,心衰组心衰前和非心衰组高血压用药方案相同。记录两组患者入院时的临床资料,包括:年龄、血糖、左心室重量指数、吸烟史、房颤、血压;入院后第2天清晨取行空腹静脉采血,测量血糖和血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。两组患者糖尿病、左室肥厚、吸烟史、房颤比较采用χ2检验;年龄、空腹血糖、血脂指标采用t检验;单因素结果中有相关性的变量进行多因素logistic回归分分析。结果心衰组左室肥厚、吸烟史发生率的较非心衰组高,空腹血糖、TC、TG、LDL-C较非心衰组高,HDL-C较非心衰组低,差异均有统计学意义(P<0.05)。左心室肥厚、吸烟史、高空腹血糖、高TC、高TG、高LDL、低HDL-C是高血压合并心力衰竭的危险因素;多因素logistic回归分析表明,左室肥厚(OR=5.61,P=0.00)、低HDL-C(OR=0.98,P=0.02)、高空腹血糖(OR=0.92,P=0.03)是高血压合并心力衰竭发生的独立危险因素。结论左室肥厚、低HDL、高空腹血糖是高血压合心力衰竭的独立相关危险因素。
Objective To investigate the risk factors of heart failure in hypertensive patients. Methods The clinical data of 115 patients with essential hypertension were retrospectively analyzed. Among them, 52 patients with heart failure as heart failure, 63 patients without heart failure as non-heart failure, heart failure before and after heart failure Hypertensive heart failure medication program the same. The clinical data of two groups were recorded at admission, including age, blood glucose, left ventricular mass index, smoking history, atrial fibrillation, blood pressure; fasting venous blood samples were taken on the second day after admission, blood glucose and blood lipid indicators [total cholesterol TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) Two groups of patients with diabetes, left ventricular hypertrophy, smoking history, atrial fibrillation compared with χ2 test; age, fasting blood glucose, blood lipid indicators using t test; single factor results were related variables multivariate logistic regression analysis. Results Compared with non-heart failure group, the incidence of left ventricular hypertrophy and smoking history in HF group was higher than that in non-HF group, fasting blood glucose, TC, TG and LDL-C were higher than those in non-heart failure group, Statistical significance (P <0.05). Left ventricular hypertrophy, smoking history, fasting blood glucose, high TC, high TG, high LDL and low HDL-C were risk factors for hypertension complicated with heart failure. Multivariate logistic regression analysis showed that left ventricular hypertrophy (OR = 5.61, P (OR = 0.98, P = 0.02). High fasting blood glucose (OR = 0.92, P = 0.03) was an independent risk factor for hypertension with heart failure. Conclusions Left ventricular hypertrophy, low HDL and high fasting blood glucose are independent risk factors of hypertension and heart failure.