老年住院患者双上肢收缩压差异的危险因素

Risk factors of inter-arm systolic blood pressure difference in the elderly inpatients

摘要:

目的 探讨影响老年住院患者双上肢收缩压差异(IASBPD)的相关因素。方法 选取2016年1月至2017年6月咸阳市第一人民医院心血管内科住院老年患者1 542例,于病情平稳或相对平稳24 h后行无创血压检测,根据IASBPD值将患者分为0～5 mmHg组570例、6～15 mmHg组834例、≥16 mmHg组138例。收集并比较3组患者体质量指数(BMI)、其他合并疾病、C-反应蛋白(CRP)等。采用logistic回归分析探讨影响IASBPD的相关因素。结果 患者总体IASBPD为(8.5±5.4)mmHg,高血压患者与无高血压患者的IASBPD分别为(10.6±5.2)mmHg和(4.3±2.6)mmHg,二者比较差异有统计学意义(P＜0.001)。单因素方差分析及单因素logistic回归显示,女性、BMI及CRP水平、高血压、高血压家族史、降压药使用、糖尿病、高脂血症及其他合并疾病是影响IASBPD的相关因素(P＜0.01)。多因素logistic回归分析显示,女性(OR=2.286,5%CI 1.784~2.929)、BMI(OR=1.101,95%CI 1.054~1.150)、高血压(OR=7.726,5%CI 5.575~10.706)、糖尿病(OR=1.701,95%CI 1.125~2.570)、高脂血症(OR=2.182,95%CI 1.660~2.869)及CRP(OR=1.260,95%CI 1.190~1.333)是影响IASBPD的独立危险因素。结论 老年住院患者IASBPD较大,高血压、女性、BMI、糖尿病、高脂血症、CRP是影响IASBPD的独立危险因素。

Abstract:

Objective To investigate the influencing factors of inter-arm systolic blood pressure difference (IASBPD) in the elderly inpatients. Methods A total of 1 542 patients admitted in our department from January 2016 to June 2017 were recruited in this study. In 24 h after being in stable or relatively stable condition, these patients underwent non-invasive blood pressure test. According to their IASBPD values, they were assigned into 0-5 mmHg group (n=570), 6-15 mmHg group (n=834), and ≥16 mmHg group (n=138). Their body mass index (BMI), other complications and C-reactive protein (CRP) were collected and compared among the 3 groups. Logistic regression analyses were applied to explore the related factors affecting IASBPD.Results The total IASBPD value was (8.5±5.4)mmHg, and the value was (10.6±5.2)mmHg and (4.3±2.6)mmHg respectively between the patients with and without hypertension (P＜0.001). Both univariate analysis of variance and univariate logistic regression analysis showed that female, BMI, CRP level, hypertension, family history of hypertension, use of hypotensive drugs, diabetes, hyperlipidemia and other complications were related factors infecting IASBPD (P<0.05). Multivariate logistic regression analysis revealed that female (OR=2.286,5%CI 1.784-2.929), BMI (OR=1.101, 95%CI 1.054-1.150), hypertension (OR=7.726, 95%CI 5.575-10.706), diabetes (OR=1.701, 95%CI 1.125-2.570), hyperlipidemia (OR=2.182, 95%CI 1.660-2.869) and CRP level (OR=1.260,5%CI 1.190-1.333) were independent risk factors for IASBPD. Conclusion IASBPD is quite larger in the elderly inpatients. Female, BMI, diabetes, hypertension, hyperlipidemia and CRP level are independent risk factors for IASBPD.