南方医科大学学报

南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (02): 240-245.doi: 10.12122/j.issn.1673-4254.2020.02.08

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高血压患者外周血红蛋白水平与动脉硬化程度显著相关

黄建玉，马 骏，郭 琰，王 瑶，张群辉，钟俊达，姜文才，李雁卓，徐 琳   

  • 出版日期:2020-03-14 发布日期:2020-02-20
  • 基金资助:

Peripheral blood albumin level in significantly correlated with the severity of atherosclerosis in hypertensive patients

  

  • Online:2020-03-14 Published:2020-02-20

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摘要： 目的 探讨外周血红蛋白（Hb）与动脉硬化的相关性。方法 采用回顾性分析方法，随机选取高血压患者419例为研究对象。采用动脉硬化测定仪检测双侧肢体的脉搏波传导速度（ba-PWV），取左右两侧较高值。根据ba-PWV值将高血压患者分为4组，S0组：动脉正常组（ba-PWV<1400 cm/s），49例（11.7%）；S1组：轻度动脉硬化组（1400 cm/s2000 cm/s），111例（26.5%）。记录其临床资料，采用多元Logistics回归分析高血压患者动脉硬化的危险因素。结果 与正常动脉组相比，不 同程度动脉硬化组之间的年龄、肥胖、白蛋白、谷丙转氨酶、总胆汁酸、腺苷脱氨酶、尿素氮、肌酐、胱抑素C、低密度脂蛋白、红细胞、血红蛋白、纤维蛋白原、FT3差异有统计学意义（P<0.05）。多元Logistic回归分析结果显示，年龄是高血压患者动脉重度硬化（OR=1.094，95%CI:1.052~1.137，P<0.05）、中度动脉硬化（OR=1.081，95%CI:1.039~1.125，P<0.05）的独立危险因素。Hb是高血压患者重度动脉硬化（OR=1.025，95%CI:1.003~1.045，P<0.05）及中度动脉硬化（OR=1.035, 95%CI:1.008~1.056，P<0.05）的新发独立危险因素，即Hb水平每增加1个标准差，高血压患者发生不同程度的动脉硬化风险增加1倍。结论 外周血红蛋白水平与高血压动脉硬化程度呈显著相关，外周血红蛋白有望成为高血压动脉硬化新的预测指标。

Abstract: Objective To investigate the relationship between peripheral blood albumin (Hb) level and the severity of arteriosclerosis in hypertensive patients. Methods This retrospective analysis was conducted among 419 randomly selected patients with hypertension. The pulse wave velocity (ba-PWV) of the bilateral limbs was measured using an arteriosclerosis tester. According to the ba-PWV value (the higher value of the two sides), the hypertensive patients were divided into 4 groups, namely normal arterial group [S0 group, ba-PWV<1400 cm/s; 49 cases (11.7%)], mild arteriosclerosis group [S1 group, ba-PWV of 1400-1800 cm/s; 190 cases (45.3%)], moderate arteriosclerosis group [S2 group, ba-PWV of 1800-2000 cm/s); 69 cases (16.5%)], and severe arteriosclerosis group [S3 group, ba-PWV >2 000 cm/s; 111 cases (26.5 %)]. The clinical data of the patients were collected and multivariate logistic regression was used to analyze the risk factors of arteriosclerosis. Results The patients’ age, obesity, albumin, alanine aminotransferase (ALT), total bile acid, adenosine deaminase, urea nitrogen, serum creatinine, cystatin C, low-density lipoprotein, red blood cells, hemoglobin (Hb), fibrinogen, and FT3 all differed significantly between S0 group and the 3 arteriosclerosis groups (P<0.05). Multivariate logistic regression analysis revealed that in hypertensive patients, age was an independent risk factor for severe arteriosclerosis (OR=1.094, 95% CI: 1.052-1.137, P<0.05) and moderate arteriosclerosis (OR= 1.081, 95% CI: 1.039-1.125, P<0.05); Hb was an independent risk factor for new-onset severe arteriosclerosis (OR= 1.025, 95% CI: 1.003-1.045, P<0.05) and moderate arteriosclerosis (OR=1.035, 95% CI: 1.008-1.056, P<0.05), and an increase of Hb levels by 1 standard deviation was associated with a doubled risk in hypertensive patients. Conclusion Peripheral Hb level is significantly correlated with the severity of arteriosclerosis and may serve as a new predictor for arteriosclerosis in hypertensive patients