缓解期慢性支气管炎对高血压患者血压变异性的影响研究

背景慢性支气管炎与高血压存在共同的危险因素,但目前国内外尚缺乏关于缓解期慢性支气管炎与高血压患者血压变异性关系的研究。目的探讨缓解期慢性支气管炎对高血压患者血压变异性的影响。方法选取2019年7月-2020年2月在宣城市人民医院心血管内科治疗的高血压患者160例为研究对象。根据患者临床诊断是否合并缓解期慢性支气管炎将其分为缓解期慢性支气管炎组24例和非缓解期慢性支气管炎组136例。收集并比较两组一般资料、血液生化指标同型半胱氨酸、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、三酰甘油、载脂蛋白A1、载脂蛋白B、脂蛋白(a)、肌酐、尿素氮、尿酸、血清葡萄糖]、24 h动态血压监测参数(白天收缩压平均值、白天舒张压平均值、白天平均血压、白天收缩压负荷、白天舒张压负荷、夜间收缩压平均值、夜间舒张压平均值、夜间平均血压、夜间收缩压负荷、夜间舒张压负荷、全天收缩压平均值、全天收缩压负荷、全天舒张压平均值、全天舒张压负荷、全天平均血压、收缩压下降率、舒张压下降率、全天脉压、24 h收缩压标准差、24 h舒张压标准差、24 h收缩压变异性、24 h舒张压变异性、动态动脉硬化指数)。采用一元线性回归分析和多元线性回归分析探讨高血压患者24 h收缩压变异性和24 h舒张压变异性的影响因素。结果缓解期慢性支气管炎组吸烟、糖尿病史者所占比例和尿素氮、尿酸高于非缓解期慢性支气管炎组(P <0.05)。缓解期慢性支气管炎组全天脉压、24 h收缩压标准差、24 h收缩压变异性大于非缓解期慢性支气管炎组(P <0.05)。一元线性回归分析结果显示,性别(B=-0.029,t=2.040)、糖尿病史(B=0.047,t=4.458)、动态动脉硬化指数(B=0.039,t=2.491)、缓解期慢性支气管炎(B=0.042,t=4.113)可能是高血压患者24 h收缩压变异性的影响因素(P <0.05);性别(B=-0.021,t=2.025)、年龄(B=0.002,t=2.112)、糖尿病史(B=0.024,t=2.393)可能是高血压患者24 h舒张压变异性的影响因素(P <0.05)。多元线性回归分析结果显示,糖尿病史(B=0.030,t=2.731)、缓解期慢性支气管炎(B=0.034,t=2.211)是高血压患者24 h收缩压变异性的影响因素(P <0.05);糖尿病史是高血压患者24 h舒张压变异性的影响因素(B=0.025,t=2.701,P <0.05)。结论缓解期慢性支气管炎是高血压患者24 h收缩压变异性的影响因素,尚未发现其是24 h舒张压变异性的影响因素。

Effect of Chronic Bronchitis in Remission on Blood Pressure Variability in Patients with Hypertension

Background There are common risk factors between chronic bronchitis and hypertension,but there is no research on the relationship between chronic bronchitis in remission and blood pressure variability in patients with hypertension at home and abroad.Objective To analyze the effect of chronic bronchitis in remission on blood pressure variability in patients with hypertension.Methods A total of 160 patients with hypertension treated in Cardiovascular Medicine,the People’s Hospital of Xuancheng City from July 2019 to February 2020 were selected as the research objects.According to the clinical diagnosis of whether the patients combined with chronic bronchitis in remission,they were divided into chronic bronchitis in remission group(n=24)and non chronic bronchitis in remission group(n=136).General data,blood biochemical indexeshomocysteine,high density lipoprotein cholesterol,low density lipoprotein cholesterol,total cholesterol,triglyceride,apolipoprotein A1,apolipoprotein B,lipoprotein(a),creatinine,urea nitrogen,uric acid,serum glucose]and parameters of 24-hour ambulatory blood pressure(mean daytime systolic blood pressure,mean daytime diastolic blood pressure,mean daytime blood pressure,daytime diastolic blood pressure load,daytime systolic blood pressure load,mean night systolic blood pressure,mean night diastolic blood pressure,mean night blood pressure,night diastolic blood pressure load,night systolic blood pressure load,all-day average systolic blood pressure,all-day systolic pressure load,all-day diastolic blood pressure,allday diastolic pressure load,all-day average blood pressure,systolic blood pressure drop rate,diastolic blood pressure drop rate,declined rate of systolic blood pressure,declined rate of diastolic blood pressure,all-day pulse pressure difference,24 h systolic blood pressure standard deviation,24 h diastolic blood pressure standard deviation,24 h systolic blood pressure variability,24 h diastolic blood pressure variability,dynamic arteriosclerosis index)of the two groups were collected and compared.Unary linear regression analysis and multiple linear regression analysis were used to explore the influencing factors of the variability of 24 h systolic blood pressure and 24 h diastolic blood pressure in patients with hypertension.Results The proportion of smoking and diabetes history,urea nitrogen and uric acid in chronic bronchitis in remission group were higher than those in non chronic bronchitis in remission group(P<0.05).The all-day pulse pressure difference,24 h systolic blood pressure standard deviation,24 h systolic blood pressure variability in chronic bronchitis in remission group were greater than those in non chronic bronchitis in remission group(P<0.05).The results of unary linear regression analysis showed that gender(B=-0.029,t=2.040),history of diabetes(B=0.047,t=4.458),dynamic arteriosclerosis index(B=0.039,t=2.491),chronic bronchitis in remission(B=0.042,t=4.113)may be the influencing factors of the variability of 24 h systolic blood pressure in patients with hypertension(P<0.05);gender(B=-0.021,t=2.025),age(B=0.002,t=2.112),history of diabetes(B=0.024,t=2.393)may be the influencing factors of the variability of 24 h diastolic blood pressure in patients with hypertension(P<0.05).The results of multiple linear regression analysis showed that the history of diabetes(B=0.030,t=2.731)and chronic bronchitis in remission(B=0.034,t=2.211)were the influencing factors of 24 h systolic blood pressure variability in hypertensive patients(P<0.05);history of diabetes was an influencing factor of 24 h diastolic blood pressure variability in hypertensive patients(B=0.025,t=2.701,P<0.05).Conclusion Chronic bronchitis in remission is an influencing factor of 24 h systolic blood pressure variability in patients with hypertension,but it has not been found to be an influencing factor of 24 h diastolic blood pressure.