Correlation between hyperuricemia and aortal elasticity in patients with H-type hypertension
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摘要:
目的 探讨H型高血压（HHT）患者血尿酸水平与主动脉顺应性的关系。 方法 以102例HHT为观察组，106例非HHT高血压患者为对照组，比较两组的病史、血脂、肾功能、肝功能等指标差异，测量肱动脉血压并通过超声心动图测量左室功能与主动脉顺应性，并分析各指标相关性。 结果 观察组高频进食海鲜（>1000 g/d, 20 vs 11）、高血压家族史例数（21 vs 10）、尿酸水平（437.28±129.32 μmol/L vs 339.58±117.89 μmol/L）、同型半胱氨酸水平（19.65±4.82 μmol/L vs 10.38±3.19 μmol/L）高于对照组（P<0.05）。观察组的左室收缩及舒张末期直径射血分数均小于对照组（P<0.05）。观察组收缩压、主动脉僵硬指数高于对照组,但舒张压、主动脉张力及膨胀指数低于对照组（P<0.05）。相关性分析显示海鲜摄入量及尿酸与主动脉张力及膨胀性指数均呈负相关，而前两者与僵硬指数正相关（P<0.05）。 结论 H型高血压患者尿酸水平高于非H型高血压患者，且尿酸及海鲜摄入量与主动脉顺应性下降相关。 Abstract:Objective To explore the relationship between the blood uric acid levels and aortic compliance of H hypertensive patients (HHT). Methods A total of 102 patients with HHT were selected as observation group and 106 patients without HHT hypertension patients as control group. Medical history, blood lipid, renal function, liver function index differences were compared. The brachial artery blood pressure were detected. The aortic compliance were measured by echocardiography and left ventricular function. The correlation of the indicators was analyzed. Results Cases of high-frequency eating seafood (>1000 g/d), family history with hypertension ,uric acid and HCY levels in observation group were significantly higher than that of control group (P<0.05). Late left ventricular systolic and diastolic diameter and ejection fraction in observation group were significantly less than that of control group (P<0.05). The systolic blood pressure and the aortic stiffness index in observation group were significantly higher than that of control group(P<0.05).The diastolic blood pressure and the aorta tension and inflation index was significantly lower than that of control group (P<0.05).Correlation analysis showed that seafood intake , uric acid and aorta tension and swelling index were in a significant negative correlation. They were positively correlated with stiffness index. Conclusion Huric acid levels are higher in hypertension patients than non hypertensive patients with type H. The uric acid and seafood intake are associated with decreased aortic compliance. -
Key words:
- H hypertension /
- uric acid /
- high purine diet /
- vascular endothelial function /
- aortic compliance
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表 1 两组患者的基线资料比较
指标 观察组（n=102） 对照组（n=106） χ2/t P 吸烟史（n） 17 21 0.344 0.594 饮酒史（n） 8 11 0.402 0.633 高频进食海鲜（n） 20 11 4.877 0.036 高血压家族史病史（n） 21 10 5.099 0.032 糖尿病史（n） 15 17 0.071 0.849 冠心病家族史（n） 18 12 1.685 0.237 总胆固醇（ $\bar x \pm s$ ，mmol/L）3.92±1.26 3.87±1.34 0.722 0.803 低密度脂蛋白（ $\bar x \pm s$ ，mmol/L）1.73±0.58 1.46±0.49 0.534 0.914 高密度脂蛋白（ $\bar x \pm s$ ，mmol/L）0.92±0.74 0.98±0.69 0.416 0.954 甘油三酯（ $\bar x \pm s$ ，mmol/L）1.21±0.82 1.08±0.99 0.439 0.837 空腹血糖（ $\bar x \pm s$ ，mmol/L）5.48±2.18 5.31±1.96 0.812 0.303 糖化血红蛋白（ $\bar x \pm s$ ，%）4.19±1.37 4.05±1.65 0.791 0.325 尿酸（ $\bar x \pm s$ ，μmol/L）437.28±129.32 339.58±117.89 9.292 0.031 肌酐（ $\bar x \pm s$ ，μmol/L）98.43±26.29 87.36±21.47 4.124 0.076 尿素氮（ $\bar x \pm s$ ，μmmol/L）3.72±0.87 3.51±0.76 0.761 0.304 总胆红素（ $\bar x \pm s$ ，μmol/L）11.52±4.19 12.28±3.75 –1.824 0.727 间接胆红素（ $\bar x \pm s$ ，μmol/L）5.73±1.28 6.01±1.54 –0.934 0.516 直接胆红素（ $\bar x \pm s$ ，μmol/L）6.23±1.52 5.47±1.39 0.913 0.502 HCY（ $\bar x \pm s$ ，μmol/L）19.65±4.82 10.38±3.19 4.016 0.026 
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表 2 两组患者超声心动图基本参数的比较（
$\bar x \pm s$ ）分组 n 左室收缩期（s） 左室收缩末内径（mm） 左室舒张末内径（mm） 左心室体积指数（%） 左室射血分数（%） 观察组 102 0.27±0.02 30.37±6.36 36.29±8.17 91.37±17.52 63.28±5.39 对照组 106 0.26±0.01 33.58±7.84 33.35±9.04 95.49±19.26 65.19±5.87 t 0.082 –1.928 2.091 –3.182 –2.131 P 1.022 0.039 0.046 0.043 0.085
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表 3 两组患者血压与主动脉顺应性参数比较（
$\bar x \pm s$ ）分组 n SBP（mmHg） DBP（mmHg） 主动脉张力（%） 主动脉膨胀性指数 主动脉僵硬指数 观察组 102 153.41±27.39 74.39±8.47 10.39±3.92 7.15±2.61 3.57±0.69 对照组 106 146.51±18.26 83.29±12.63 13.27±4.03 8.29±2.91 1.35±0.27 t 6.826 –4.581 –3.493 –1.274 2.191 P 0.033 0.042 0.039 0.044 0.031
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表 4 主动脉顺应性与进食海鲜及尿酸的相关性分析
指标 主动脉张力 主动脉膨胀性指数 主动脉僵硬指数 r P r P r P 高频进食海鲜 –0.626 0.017 –0.602 0.023 0.583 0.035 尿酸 –0.653 0.013 0.631 0.019 0.594 0.031
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