分析不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性

来源期刊：广州医药 | 770-775 发布时间：2024-08-21 收稿时间：2025/11/13 18:47:22 阅读量：43

作者：: 高辉,

曹玉枝,

陈建都,

孙婷婷,

黄一玲,

关键词：: 高血压血压变异性空腹甘油三酯血糖指数血管内皮功能相关性高血压分级; hypertension blood pressure variability fasting triglyceride blood glucose index vascular endothelial function correlation hypertension classification

DOI：: 10.3969/j.issn.1000-8535.2024.07.012

收稿时间：: 2023-12-28
修订日期：
接收日期：
引用总数：: 0

目的探讨不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性。方法选取天津市第一医院2020年10月—2023年10月收治的150例高血压患者作为研究对象,将患者分为：1级组（n=50）,即140~159 mmHg和（或）舒张压90~99 mmHg,2级组（n=60）,即收缩压160~179 mmHg和（或）舒张压100~109 mmHg,3级组（n=40）,即收缩压≥180 mmHg和（或）舒张压≥110 mmHg。测量所有患者收缩压加权标准差（SBP_wSD）和舒张压加权标准差（DBP_wSD）评价血压变异性,检测空腹血糖、空腹甘油三酯水平,计算空腹甘油三酯血糖指数（TyG）,以及记录丙二醛（MDA）、一氧化氮（NO）、内皮素-1（ET-1）、超氧化物歧化酶（SOD）水平对内皮功能进行评价。采用Spearman相关分析法分析血压变异性与空腹TyG及内皮功能的相关性。结果 1级组DBP_wSD、SBP_wSD低于2级组和3级组（P<0.05）;1级组空腹血糖、空腹甘油三酯、TyG低于2级组和3级组（P<0.05）;1级组MDA、ET-1低于2级组和3级组,NO、SOD高于2级组和3级组（P<0.05）; DBPwSD、SBPwSD与空腹血糖、空腹甘油三酯无关（P>0.05）,DBP_wSD、SBP_wSD与NO、SOD水平呈负相关,与TyG、MDA、ET-1呈正相关（P<0.05）。结论不同血压分级的高血压患者血压变异性、TyG及血管内皮功能具有明显差异,且高血压患者血压变异性与TyG和血管内皮功能具有明显相关性。

Objective To explore the correlation between blood pressure variability and fasting triglyceride blood glucose index and endothelial function in different hypertension grades．Methods A total of 150 hypertensive patients admitted to our hospital from October 2020 to October 2023 were selected as study participants．Patients were classified into group level 1 （n=50）,with systolic blood pressure 140~159 mmHg and/or diastolic blood pressure 90~99 mmHg,group level 2（n=60）,with systolic blood pressure 160~179 mmHg and/or diastolic blood pressure 100~109 mmHg,and group level 3（n=40）,with systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg．SBPwSD and DBP_wSD of all patients were measured to assess their blood pressure variability．Fasting blood glucose and fasting triglyceride levels were measured to calculate TyG．MDA,NO,ET-1 and SOD were used to evaluate endothelial function．The correlation between blood pressure variability and glycemic index and endothelial function was analysed using Spearman correlation analysis．Results The DBP_wSD and SBP_wSD of the group level 1 were significantly lower than those of the groups level 2 and 3（P<0.05）．The fasting blood glucose,fasting triglycerides and TyG in the group level 1 were significantly lower than those in the groups level 2 and 3（P<0.05）．MDA and ET-1 values in the group level 1 were significantly lower than in the groups level 2 and 3,while NO and SOD values in the group level 1 were significantly higher than those in the other two groups（P<0.05）．DBP_wSD and SBP_wSD did not correlate significantly with fasting blood glucose and fasting triglycerides（P>0.05）,while DBP_wSD and SBP_wSD correlated negatively with NO and SOD values and correlated positively with TyG,MDA and ET-1（P<0.05）．Conclusions There are significant differences in blood pressure variability,TyG,and endothelial function among hypertensive patients with different grades,and there is a significant correlation between blood pressure variability and TyG and endothelial function in hypertensive patients．

1、李婧,李小凤,余湘尤,等.胰岛素抵抗代谢评分与高血压的相关性研究[J].重庆医学,2023,52(15):2310-2314.

2、范洋溢,徐燕,彭莉,等.血压变异性与老年脑血管病患者脑小血管病进展风险的研究[J].中华老年心脑血管病杂志,2021,23(4):356-359.

3、程雪莲,金俊,谈世进.80岁及以上老年高血压合并衰弱病人的血压变异性研究[J].实用老年医学,2023,37(5):509-511.

4、刘宝. 原发性高血压病人血清25(OH)D与血压波动性和血管内皮功能的关系探讨[J].中西医结合心脑血管病杂志,2022,20(16):3004-3007.

5、陈斌,铁明慧,魏丹霞,等.基于”阴阳失调”理论探讨高血压血管内皮功能障碍的中医病因病机[J].中西医结合心脑血管病杂志,2021,19(13):2281-2284.

6、杨爽,白莎,王恒,等.老年高血压患者心功能、外周血管阻力与血清Hcy、血脂水平的相关性研究[J].中国循证心血管医学杂志,2021,13(1):47-50.

7、马琳,游广辉,戚志平,等.β-七叶皂苷钠联合依达拉奉治疗老年高血压脑出血术后病人的疗效观察[J].中西医结合心脑血管病杂志,2021,19(10):1745-1748.

8、唐延甜,何志鹏,陈檀琦.比索洛尔联合参松养心胶囊对围绝经期高血压患者血压血管内皮功能及睡眠的影响[J].中国妇幼保健,2022,37(5):929-932.

9、王振强,张淑芳,吕树泉,等.参黄降糖胶囊对糖尿病合并高血压病人血管内皮功能、血液流变学的影响[J].安徽医药,2023,27(6):1249-1252.

10、王丽,夏大胜,李超,等.沉默信息调节因子3在高血压和内皮功能障碍中的研究进展[J].中华高血压杂志,2023,31(9):831-834.

11、张梦玮,徐长江,段洋,等.利用TyG指数评估急性心肌梗死患者的预后[J].中国循证心血管医学杂志,2021,13(4):499-503.

12、梁蒙,陈伟国,王新玲.三酰甘油血糖指数用于预测高血压合并糖尿病患者下肢动脉硬化的研究[J].标记免疫分析与临床,2022,29(8):1297-1302.

13、曲歌乐,张仲迎,曹若瑾.血脂相关指标对血压达标中老年高血压患者动脉僵硬度的影响[J].山东医药,2021,61(11):32-36.

14、王若楠,张德生,白朝,等.甘油三酯、空腹血糖及甘油三酯葡萄糖乘积指数与高血压发病风险的前瞻性队列研究[J].中华流行病学杂志,2021,42(3):482-487.

15、 SIM?ES CORRêA GALENDI J,LEITE RGOF,BANZATO L R,et al.Effectiveness of strategies for nutritional therapy for patients with type 2 diabetes and/or hypertension in primary care:A systematic review and meta-analysis[J].Int J Environ Res Public Health,2022,19(7):4243.

16、 LEACHE L,GUTIéRREZ-VALENCIA M,FINIZOLA R M,et al.Pharmacotherapy for hypertension-induced left ventricular hypertrophy[J].Cochrane Database Syst Rev,2021,10(10):CD012039.

17、 HIBINO M,OTAKI Y,KOBEISSI E,et al.Blood pressure,hypertension,and the risk of aortic dissection incidence and mortality:Results from the J-SCH study,the UK biobank study,and a meta-analysis of cohort studies[J].Circulation,2022,145(9):633-644.

18、刘力生. 中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.

19、王增武,赵连友,钟巧青,等.赓续前行谱新篇:我国高血压防治的发展[J].中国心血管病研究,2021,19(10):865-869.

20、刘迪,蔡润泽,张琴,等.调脂治疗对改善老年高血压患者内皮功能紊乱与线粒体自噬功能的影响[J].中华老年心脑血管病杂志,2023,25(3):233-237.

21、曾荣,闫家富,郑恪扬,等.空腹甘油三酯血糖指数与原发性高血压患者动脉硬化的相关性研究[J].中华全科医学,2021,19(8):1262-1264,1286.

22、 SACO-LEDO G,VALENZUELA P L,RUIZ-HURTADO G,et al.Exercise reduces ambulatory blood pressure in patients with hypertension:A systematic review and meta-analysis of randomized controlled trials[J].J Am Heart Assoc,2020,9(24):e018487.

23、 FU J,LIU Y,ZHANG L,et al.Nonpharmacologic interventions for reducing blood pressure in adults with prehypertension to established hypertension[J].J Am Heart Assoc,2020,9(19):e016804.

24、 SILVA G F S,FAGUNDES T P,TEIXEIRA B C,et al.Machine learning for hypertension prediction:A systematic review[J].Curr Hypertens Rep,2022,24(11):523-533.