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目的分析血清D-二聚体(D-D)水平与老年高血压患者左心室肥厚(LVH)的相关性。方法选取2014年6月—2016年1月应城市人民医院收治的老年高血压患者160例,根据LVH发生情况分为LVH组67例和非LVH组93例。记录两组患者一般资料、实验室检查指标及心脏超声检查指标。相关性分析采用Pearson相关分析;影响因素的分析采用多因素logistic回归分析。结果两组患者年龄、性别、体质指数(BMI)、吸烟率、饮酒率、血脂异常发生率、舒张压(DBP)及血清血肌酐(Scr)、尿素氮(BUN)水平比较,差异无统计学意义(P>0.05);LVH组患者高血压病程长于非LVH组,收缩压(SBP)及血清超敏C反应蛋白(hs-CRP)、N-末端脑钠肽(NT-pro BNP)、D-D水平高于非LVH组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血清D-D水平与老年高血压患者血清NT-pro BNP水平及左心室重量指数(LVMI)、左心室舒张末期内径(LVEDD)、左心房内径(LA)呈正相关(P<0.05),与左心室射血分数(LVEF)呈负相关(P<0.05),而与室间隔厚度(IVST)、左心室后壁厚度(LVPWT)无直线相关性(P>0.05)。多因素logistic回归分析结果显示,高血压病程、SBP及血清NT-pro BNP、hs-CRP、D-D水平是老年高血压患者LVH的独立危险因素(P<0.05)。结论血清D-D水平是老年高血压患者LVH的独立危险因素。
Objective To analyze the correlation between serum D-dimer (D-D) level and left ventricular hypertrophy (LVH) in elderly hypertensive patients. Methods 160 elderly hypertensive patients admitted to Yingcheng People’s Hospital from June 2014 to January 2016 were selected and divided into 67 cases of LVH and 93 cases of non-LVH according to the occurrence of LVH. Record two groups of patients general information, laboratory tests and echocardiographic indicators. Correlation analysis using Pearson correlation analysis; analysis of influencing factors using multivariate logistic regression analysis. Results There were no significant differences in age, sex, body mass index (BMI), smoking rate, alcohol drinking rate, incidence of dyslipidemia, DBP, serum creatinine (Scr) and blood urea nitrogen (P> 0.05). The duration of hypertension in LVH group was longer than that in non-LVH group, systolic blood pressure (SBP), serum hs-CRP, NT-pro BNP, The level was higher than non-LVH group, the difference was statistically significant (P <0.05). Pearson correlation analysis showed that serum DD level was positively correlated with serum NT-pro BNP level and LVMI, LVEDD and LA in elderly patients with hypertension (P <0.05) ), But negatively correlated with left ventricular ejection fraction (LVEF) (P <0.05), but not with IVST and LVPWT (P> 0.05). Multivariate logistic regression analysis showed that the duration of hypertension, SBP and serum NT-pro BNP, hs-CRP and D-D levels were independent risk factors of LVH in elderly patients with hypertension (P <0.05). Conclusions Serum D-D level is an independent risk factor for LVH in elderly patients with hypertension.