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目的探讨新疆维吾尔族、汉族高血压患者颈动脉斑块与血压变异性(BPV)的关系。方法选取2010年2月至2013年4月就诊于新疆医科大学第一附属医院高血压科住院的原发性高血压患者1080例(汉族635例,维吾尔族445例)临床资料进行回顾性分析,对颈动脉斑块的相关危险因素进行多因素Logistic回归分析。结果同民族颈动脉斑块组与无斑块组在年龄、高血压病程、24h平均收缩压、24h平均舒张压、24h收缩压标准差、白天和夜间平均收缩压、白天和夜间平均舒张压、白天和夜间收缩压标准差、24h平均心率、总胆固醇、低密度脂蛋白胆固醇(LDL-C)等差异有统计学意义(均P<0.05)。多因素回归分析结果显示,总人群颈动脉斑块与年龄、吸烟、LDL-C、24h平均收缩压、夜间平均收缩压、24h收缩压标准差、夜间收缩压标准差呈正相关(OR分别为1.085、1.803、1.548、1.017、1.028、1.695、1.096,均P<0.05),汉族人群患颈动脉斑块的风险低于维吾尔族(OR=0.615,P<0.05)。汉族高血压患者颈动脉斑块与年龄、吸烟、LDL-C、24h平均收缩压、夜间平均收缩压、24h收缩压标准差、夜间收缩压标准差呈正相关(OR分别为1.081、2.157、1.565、1.026、1.026、1.600、1.082,均P<0.05),与24h平均心率呈负相关(OR=0.971,P<0.05)。维吾尔族高血压患者颈动脉斑块与年龄、夜间平均收缩压、24h收缩压标准差及夜间收缩压标准差呈正相关(OR分别为1.088、1.028、1.743、1.108,均P<0.05)。在总人群、汉族及维吾尔族人群中,24h收缩压标准差每增加5.55mm Hg,颈动脉斑块形成危险分别增加69.5%、60.0%和74.3%(均P<0.05)。结论新疆维吾尔族、汉族两民族高血压患者颈动脉斑块与24h收缩压标准差呈正相关,汉族人群颈动脉斑块风险低于维吾尔族人群。
Objective To investigate the relationship between carotid plaque and blood pressure variability (BPV) in Uygur and Han nationality in Xinjiang. Methods A retrospective analysis of 1,080 cases (635 Han cases and 445 Uighurs) of hypertensive patients admitted to the Hypertension Unit of the First Affiliated Hospital of Xinjiang Medical University from February 2010 to April 2013 was retrospectively analyzed. Multivariate Logistic regression analysis was performed on the related risk factors of carotid plaque. Results Compared with age group, duration of hypertension, mean systolic blood pressure 24h, mean diastolic blood pressure 24h, standard systolic blood pressure 24h, mean systolic blood pressure during daytime and nighttime, mean diastolic blood pressure during daytime and nighttime, The standard deviation of systolic blood pressure at daytime and nighttime, 24h mean heart rate, total cholesterol and low density lipoprotein cholesterol (LDL-C) were significantly different (all P <0.05). Multivariate regression analysis showed that there was a positive correlation between carotid plaques and age, smoking, LDL-C, 24h mean systolic pressure, nighttime average systolic pressure, 24h systolic pressure standard deviation and nighttime systolic blood pressure standard deviation (OR = 1.085 , 1.803,1.548,1.017,1.028,1.695,1.096, all P <0.05). The risk of carotid plaque in Han population was lower than that in Uyghur population (OR = 0.615, P <0.05). Carotid artery plaque was positively correlated with age, smoking, LDL-C, 24h mean systolic pressure, nighttime average systolic pressure, 24h systolic pressure standard deviation and nighttime systolic blood pressure standard deviation (OR = 1.081,2.157,1.565, 1.026,1.026,1.600,1.082, all P <0.05), and had a negative correlation with 24h mean heart rate (OR = 0.971, P <0.05). Carotid artery plaque was positively correlated with age, nighttime mean systolic pressure, 24h systolic pressure standard deviation and nighttime systolic blood pressure standard deviation in Uighur hypertensive patients (OR = 1.088,1.028,1.743,1.108, all P <0.05). In the general population, Han nationality and Uygur nationality, every increase of standard deviation of systolic blood pressure of 24 h was 5.55 mm Hg, the risk of carotid plaque formation increased by 69.5%, 60.0% and 74.3% respectively (all P <0.05). Conclusions There is a positive correlation between carotid plaque and systolic blood pressure (24h) systolic pressure in both Uygur and Han ethnic groups in Xinjiang. The risk of carotid plaque in Han nationality is lower than that in Uyghur ethnic groups.