采用结构方程模型分析心理压力对原发性高血压患者血压及生化指标水平的影响

发布时间：2018-06-16 02:38

  本文选题：原发性高血压 + 心理压力　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:采用结构方程模型分析心理压力对血压及各生化指标作用的直接途径和间接途径。方法:选取2015年1月至2017年3月于新疆医科大学第五附属医院门诊就诊、住院患者及体检中心健康体检者的连续病例,依据原发性高血压的诊断标准,将所有满足本研究研究对象共600人,均完善身高、体重、腹围、体重指数、年龄、性别等基本临床资料,测量血压和生化指标,并完善知觉压力量表。将研究对象分为四组:高压力高血压组(HPPH,n=150)、低压力高血压组(LPPH,n=150)、高压力对照组(HPPC,n=150)、低压力对照组(LPPC,n=150),对各组的基本资料及生化指标进行相关统计学分析。然后采用SEM方法探讨心理压力对血压及各生化指标影响的直接途径和间接途径,认为P0.05为差异具有统计学意义,采用Amos21.0软件进行结构方程模型统计分析。结果:1.经方差分析结果提示:HPPH的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于其它三组;LPPH的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于HPPC和LPPC;HPPC的SBP、DBP、TC、TG、LDL-C、AngⅡ、ALD和Hcy均高于LPPC;而HDL-C与之相反,差异均有统计学意义(P0.05)。2.经SEM分析结果显示:心理压力对血压(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)、AngII、ALD、Hcy影响显著(P0.05),与血压(SBP,DBP)、血脂(TC,TG,LDL-C)、Ang II、ALD、Hcy呈正向关系(P0.05);与HDL-C呈负向关系(P0.05)。AngII对血压(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)影响显著(P0.05),与血压(SBP,DBP),血脂(TC,TG,LDL-C)呈正向关系(P0.05),与HDL-C呈负向关系(P0.05)。ALD对血压(SBP,DBP)、血脂(TC,TG,LDL-C,HDL-C)影响显著(P0.05),与血压(SBP,DBP),血脂(TC,TG,LDL-C)呈正向关系(P0.05),与HDL-C呈显著负向关系(P0.05);血压(SBP,DBP)对血脂(TC,TG,LDL-C,HDL-C)、Hcy影响显著(P0.05),与TC、TG、LDL-C、Hcy呈正向关系(P0.05);与HDL-C呈负向关系(P0.05)。结论:1心理压力使EH患者血压(SBP、DBP)水平升高,心理压力越大,血压水平越高。2心理压力使EH患者血脂(TC、TG和LDL-C)和Hcy水平升高,而使HDL-C水平降低;心理压力越大,TC、TG、LDL-C,Hcy水平越高,而HDL-C水平越低。3心理压力使EH患者AngⅡ和ALD升高,间接导致血压和血脂水平升高,心理压力越大,Ang II和ALD水平越高,进而血压和血脂水平越高。4血压使血脂(TC、TG和LDL-C)和Hcy水平升高,而使HDL-C水平降低;血压水平越高,TC、TG、LDL-C,Hcy水平越高,而HDL-C水平越低。
[Abstract]:Aim: to analyze the direct and indirect effects of psychological pressure on blood pressure and biochemical indexes by structural equation model. Methods: from January 2015 to March 2017, consecutive cases were selected from outpatients, inpatients and health examiners in the Fifth affiliated Hospital of Xinjiang Medical University, according to the diagnostic criteria of essential hypertension. All 600 subjects were selected to complete the basic clinical data, such as height, weight, abdominal circumference, body mass index, age and sex, to measure blood pressure and biochemical indexes, and to perfect the perceptual stress scale. The subjects were divided into four groups: high pressure hypertension group, low pressure hypertension group, high pressure control group and low pressure control group. The basic data and biochemical indexes of each group were analyzed statistically. Then the direct and indirect ways of the influence of psychological pressure on blood pressure and biochemical indexes were discussed by using Amos21.0 software. The results showed that P0.05 was statistically significant. The statistical analysis of structural equation model was carried out by using Amos21.0 software. The result is 1: 1. The results of ANOVA showed that the ALD and Hcy of the two groups were higher than those of the other three groups, and the ALD and Hcy of the two groups were higher than those of the HPPC and LPPCHPPC, but the difference of HDL-C and HDL-C was statistically significant (P0.05n.2.The results showed that the ALD and Hcy of the two groups were higher than those of the HPPC and the LPPCHPPC. The results showed that the ALD and Hcy of the two groups were higher than those of the other three groups. The results of SEM analysis showed that psychological stress had a significant effect on blood pressure SBP, TGLDL-C, HDL-LDL-C, and Hcy, and had a positive relationship with blood pressure (SBP), blood lipid (TCG), LDL-C (Ang IIALD) Hcy (P0.05), negative relationship with HDL-C (P 0.05 .AngII), TCG-TGLDL-C (HDL-C), and blood pressure (P < 0.05), blood lipid (TCC) TGLDL-C (HDL-C), blood pressure (P < 0.05), blood lipid (TCC) TGLDL-C (HDL-C), blood lipid (TCC) TGLDL-C (P < 0.05), and TCCT TGLDL-C (P < 0.05), and TCCT TGLDL-C (TGLDL-C) were positively correlated with blood pressure (P < 0.05), and TCC TGLDL-C (TGLDL-C) were positively correlated with blood pressure (P < 0.05). There was a negative relationship between P0.05A and HDL-C. ALD had a significant effect on blood pressure and TGLDL-Con HDL-C0. 05, a positive relationship with blood pressure SBP0. 05, a positive relationship between TGLDL-C0. 05 and HDL-C, and a negative relationship with HDL-C, and a negative relationship between blood pressure SBPDBP0. 05 and TCTGLDL-Ch Hcy, a positive relationship with TCTGLDL-Cy, and a negative relationship of P0. 05 with TCTGLDL-C0. 05. the relationship between Hcy and TCTGLDL-Cy was positive (P0. 05), and a negative correlation was found between TGLDL-HDL-Hcy and TC- TGLDL-Hcy (P0. 05), and a negative relationship between TGLDL-Hcy and TC- TGLDL-Hcy was observed (P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P0. 05, P 0. 05, respectively). Conclusion the higher the psychological stress, the higher the level of TCU TG, LDL-C) and Hcy, but the lower the level of HDL-C, the higher the psychological stress, the higher the level of LDL-Ccy and TG, the higher the level of LDL-Ccy, the higher the psychological stress, the higher the level of LDL-Ccy, and the higher the level of TCG-LDL-Ccy, the higher the level of TCG-LDL-CHcy, the higher the level of TCG-LDL-Ccy. The lower the level of HDL-C was, the lower the psychological stress was, the higher the level of Ang 鈪，

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