摘要
目的 探讨肥胖型高血压患者颈动脉体化学感受器敏感性(CBRS)与血压控制的相关性.方法 选取2022 年1 月至2023 年12 月收治的202 例肥胖型高血压患者作为观察组,另选取同期肥胖血压正常患者101 例作为对照组,同期健康志愿者101 例作为正常组.比较3 组CBRS、体质量指数(BMI)、血压.观察组均按指南给予相关治疗3 个月,根据血压控制情况分为控制良好亚组(n=148)与控制不良亚组(n=54),对比两亚组临床特征、CBRS,分析CBRS与BMI、收缩压、舒张压的相关性,评价CBRS、BMI、收缩压、舒张压对血压控制的预测价值及CBRS对血压控制的影响.结果 观察组CBRS低于对照组、正常组,对照组CBRS低于正常组(P＜0.05);观察组及对照组BMI高于正常组,观察组收缩压、舒张压高于对照组及正常组(P＜0.05);控制不良亚组BMI、收缩压、舒张压高于控制良好亚组,CBRS低于控制良好亚组(P＜0.05,P＜0.01);CBRS与 BMI、收缩压、舒张压呈负相关(r=-0.672、-0.710、-0.695,P＜0.05).CBRS、BMI、收缩压、舒张压联合预测血压控制的曲线下面积大于各指标单独预测(P＜0.05).以最佳截断值为界将CBRS分为低值与高值,CBRS低值的肥胖型高血压患者血压控制不良风险是CBRS高值的肥胖型高血压患者7.143 倍.结论 肥胖型高血压患者CBRS与BMI、收缩压、舒张压及血压控制不良风险密切相关,可作为预测血压控制情况的重要指标.
Abstract
Objective To investigate the correlation between carotid body chemoreceptor sensitivity(CBRS)and blood pressure control in obese hypertensive patients.Methods A total of 202 obese hypertensive patients admitted from Jan-uary 2022 to December 2023 were selected as the observation group,and another 101 obese patients with normal blood pres-sure during the same period were selected as the control group.Another 101 healthy volunteers during the same period served as the normal group.The CBRS,body mass index(BMI),and blood pressure were compared among the three groups.The observation group was given relevant treatment for 3 months according to the guidelines,and divided into a well-controlled sub-group(n=148)and an poorly-controlled subgroup(n=54)based on blood pressure control.The clinical characteristics and CBRS of the two subgroups were compared,and the correlation between CBRS and BMI,systolic blood pressure(SBP),dias-tolic blood pressure(DBP)was analyzed to evaluate the predictive value of CBRS,BMI,SBP,and DBP for blood pressure control and the influence of CBRS on blood pressure control.Results The CBRS of the observation group was lower than that of the control group and the normal group,and lower in the control group than in the normal group(P＜0.05).The BMI of the observation group and the control group was higher than that of the normal group,and SBP and DBP of the observation group were higher than those of the control group and the normal group(P＜0.05).BMI,SBP and DBP of the poorly-controlled subgroup were higher than those of the well-controlled subgroup,and the CBRS was lower than that of the well-controlled subgroup(P＜0.05,P＜0.01).CBRS was negatively correlated with BMI,SBP and DBP(r=-0.672,-0.710,-0.695,P＜0.05).The area under the curve of CBRS,BMI,SBP and DBP for the combined prediction of blood pressure control was greater than that of each indicator alone(P＜0.05).The CBRS was categorized into low and high values using the optimal cutoff value as a boundary,and the risk of poor blood pressure control in obese hypertensive patients with a low CBRS was 7.143 times higher than that in obese hypertensive patients with a high CBRS.Conclusion CBRS in obese hypertensive patients is strongly associated with BMI,SBP,DBP,and risk of poor blood pressure control,and can be used as an important predictor of blood pressure control.
维普
万方数据