血红蛋白水平升高的高血压前期患者的临床特点及高盐饮食对其远期预后的影响

doi:10.3969/j.issn.1001-9057.2019.10.007

摘要/Abstract

摘要： 目的探讨血红蛋白(Hb)水平升高的高血压前期患者的临床特点及高盐饮食对其远期预后的影响。方法纳入高血压前期患者421例，根据基线中位Hb水平分为A组(Hb≤138g/L)217例和B组(Hb＞138g/L)204例，比较两组患者的临床资料和预后。同时根据盐摄入量将B组患者分为高盐组117例与正盐组87例，比较两组患者的临床资料和预后。采用Cox回归分析评估B组患者随访期间发展为高血压和发生主要不良心脑血管事件（MACCE）的危险因素。结果 A组单支冠状动脉(简称冠脉)病变患者比例、Gensini评分及病变冠脉数量均低于B组；冠脉无病变患者比例高于B组（P＜0.05）。随访期间，B组发展为高血压和发生MACCE患者比例均高于A组（P＜0.05）。Kaplan-Meier曲线分析结果显示，B组患者随访期间高血压及MACCE的累计发生率均高于A组（P＜0.05）。Cox回归分析结果显示，高盐饮食和糖尿病病史均为B组患者随访期间发展为高血压和发生MACCE的独立危险因素（P＜0.05）。高盐组发生MACCE患者比例均高于正盐组（P＜0.05）。Kaplan-Meier曲线分析结果显示，高盐组患者随访期间高血压及MACCE的累计发生率均高于正盐组（P＜0.05）。结论 Hb水平升高的高血压前期患者冠脉病变重，随访期间高血压及MACCE的发生率较高，高盐饮食可进一步导致其高血压和MACCE的发生。

关键词: 高血压前期; 血红蛋白; 高盐饮食; 高血压

Abstract: Objective To explore the clinical characteristics of patients with pre-hypertension accompanied by increased hemoglobin(Hb) level and effect of high-salt diet on their long-term prognosis.Methods A total of 421 patients with pre-hypertension were divided into group A(Hb≤138g/L,217 cases) and group B(Hb>138g/L,204 cases) according to baseline median Hb level dichotomies.Clinical data and prognosis of the two groups were compared.At the same time,patients in group B were divided into high salt group(117 cases) and normal salt group(87 cases) according to the salt intake.Clinical data and prognosis of the two groups were compared.Cox regression analysis was used to assess risk factors for developing hypertension and MACCE during follow-up in group B patients.Results Proportions of patients with single coronary artery lesion,Gensini score and number of diseased coronary arterys in group A were lower than those in group B,while proportion of patients with no coronary artery lesion was higher than those in group B(P＜0.05).During follow-up,proportions of patients with hypertension and MACCE in group B were higher than those in group A(P＜0.05).Kaplan-Meier curve analysis showed that incidences of hypertension and MACCE in patients of goup B were higher than those of group A(P＜0.05).Cox regression analysis showed that both high salt diet and diabetes history were independent risk factors for hypertension and MACCE during follow-up in group B(P＜0.05).Proportions of patients with MACCE in high salt group was higher than those in normal salt group(P＜0.05).Kaplan-Meier curve analysis showed that incidence of hypertension and MACCE in high salt group were higher than those in normal salt group(P＜0.05).Conclusion Coronary lesions in patients with pre-hypertension accompanied by increased Hb level is serious Incidence rates of hypertension and MACCE during follow-up are high,and high salt diet can furtherly lead to the occurrence of hypertension and MACCE.

Key words: Prehypertension; Hemoglobin; Highsalt diet; Hypertension

徐培, 艾冠男, 刘一飞, 王兆丰, 张玉婕, 杨晓旭, 顾崇怀, 赵昕. 血红蛋白水平升高的高血压前期患者的临床特点及高盐饮食对其远期预后的影响[J]. 临床内科杂志, 2019, 36(10): 668-672.

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血红蛋白水平升高的高血压前期患者的临床特点及高盐饮食对其远期预后的影响

Clinical characteristics of patients with pre-hypertension accompanied by increased hemoglobin level and effect of highsalt diet on their long-term prognosis

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