高血压患者性别差异内皮功能障碍危险因素研究

发布时间：2018-12-14 08:55

【摘要】：目的血管内皮功能障碍参与心血管疾病的病理生理改变,且发挥重要作用。然而,性别差异内皮功能障碍危险因素相关研究结论不一。为此,我们拟在高血压患者中探讨性别差异内皮功能障碍危险因素。方法纳入213例高血压患者,通过测定反应性充血指数(reactive hyperemia index,RHI)反应血管内皮功能。收集患者外周血,记录吸烟、饮酒、年龄、体质指数、心率、血压及用药情况。结果男性及女性高血压患者RHI均下降[男性1.60(1.38-2.02)vs.女性1.63(1.44-1.98)]。多因素logistic回归表明,血清肌酐(p0.001)、总胆固醇(p=0.001)、同型半胱氨酸(0.002)及吸烟(p0.001)与性别(男性)独立相关。多因素线性回归分析进一步表明,血清同型半胱氨酸水平与女性高血压患者RHI独立相关(OR:-0.166;95%可信区间:-0.292,-0.040;p=0.01)。而在男性患者未证实上述相关性。结论在高血压患者中,血管内皮功能障碍相关危险因素存在性别差异。血清同型半胱氨酸水平是女性高血压患者内皮功能障碍独立危险因素。
[Abstract]:Objective Vascular endothelial dysfunction plays an important role in the pathophysiological changes of cardiovascular diseases. However, gender differences in endothelial dysfunction related to risk factors are not consistent. Therefore, we intend to explore the risk factors of gender difference endothelial dysfunction in hypertensive patients. Methods Endothelial function was measured by reactive hyperemia index (reactive hyperemia index,RHI) in 213 patients with hypertension. Peripheral blood was collected, smoking, drinking, age, body mass index, heart rate, blood pressure and medication were recorded. Results RHI decreased in both male and female patients with hypertension [male 1.60 (1.38-2.02) vs.] Female 1.63 (1.44-1.98). Multivariate logistic regression showed that serum creatinine (p0. 001), total cholesterol (p0. 001), homocysteine (0.002) and smoking (p0. 001) were independently correlated with sex (male). Multivariate linear regression analysis further showed that serum homocysteine level was independently correlated with RHI in female patients with hypertension (OR:-0.166;95% confidence interval: -0.292 ~ -0.040). This correlation was not confirmed in male patients. Conclusion there are gender differences in the risk factors of vascular endothelial dysfunction in patients with hypertension. Serum homocysteine level is an independent risk factor for endothelial dysfunction in women with hypertension.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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