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摘要:
目的 探究身体形态指数(a body shape index, ABSI)与高血压靶器官损伤的关系。 方法 本研究为横断面调查，研究对象为2020年3月至2021年1月于陆军军医大学附属大坪医院心血管内科住院的高血压患者。采用ASBI三分位数法，将其分为低ASBI组、中ASBI组和高ASBI组。比较3组高血压靶器官损伤检出率差异。采用多因素Logistic回归分析ASBI与高血压靶器官损伤的相关性。 结果 共入选685例符合纳入和排除标准的高血压患者，其中存在靶器官损伤445例；低ASBI组(ABSI≤0.076)229例、中ASBI组(0.076＜ABSI≤0.078)228例、高ASBI组(ABSI＞0.078)228例。高ASBI组左心室肥厚检出率高于低ASBI组(27.63%比12.66%，P＜0.001)，颈动脉粥样硬化、肾功能损伤检出率高于中ASBI组(39.04%比26.32%，P=0.015；14.04%比5.26%，P=0.007)和低ASBI组(39.04%比25.76%，P=0.008；14.04%比2.62%，P＜0.001)。多因素Logistic回归分析结果显示，以低ABSI为参照，高ABSI是高血压患者发生左心室肥厚(OR=2.08，95% CI: 1.24~3.50, P＜0.001)、肾功能损伤(OR=6.47，95% CI: 2.53~16.54, P＜0.001)的独立危险因素。 结论 ABSI升高与高血压患者肾功能损伤、左心室肥厚具有关联性。 Abstract:Objective To explore the correlation between a body shape index (ABSI) and target organ injury in patients with hypertension. Methods A cross-sectional study was used to collect related clinical indicators of patients with hypertension who were hospitalized in the Department of Cardiology, Daping Hospital, Third Military Medical University from March 2020 to January 2021. ASBI quantile method was used to divide the patients into low ASBI group, medium ASBI group and high ASBI group. Multiple Logistic regression was used to analyze the correlation between ASBI and target organ injury in patients with hypertension. Results A total of 685 patients with hypertensive meeting the inclusion and exclusion criteria were enrolled, of which 445 had target organ damage; 229 cases were in the low ASBI group (ABSI≤0.076), 228 cases were in the medium ASBI group (0.076 < ABSI≤0.078), 228 cases were in the high ASBI group (ABSI > 0.078). The detection rate of left ventricular hypertrophy in the high ASBI group was higher than that in the low ASBI group(27.63% vs. 12.66%, P < 0.001). The detection rates of carotid atherosclerosis, and renal function impairment of the high ASBI group were higher than those of the medium ASBI group(39.04% vs. 26.32%, P=0.015;14.04% vs. 5.26%, P=0.007) and low ASBI group(39.04% vs. 25.76%, P=0.008;14.04% vs. 2.62%, P < 0.001). The multivariate Logistic regression analysis showed that ABSI was associated with increased left ventricular hypertrophy (OR=2.08, 95% CI: 1.24-3.50, P < 0.001) and renal injury (OR=6.47, 95% CI: 2.53-16.54, P < 0.001) in hypertensive patients. Conclusion The increased ABSI is related to the prevalence of left ventricular hypertrophy and renal damage in hypertensive patients. -
Key words:
- a body shape index /
- hypertension /
- target organ injury /
- left ventricular hypertrophy /
- renal damage
作者贡献：李方塘负责研究方案框架设计、临床数据收集、统计分析及论文撰写；杨小利负责研究方案设计与技术指导；陈瑞丹负责临床数据收集和统计分析；杨永健负责研究方案设计审核、协调工作计论文修订。利益冲突：所有作者均声明不存在利益冲突 -
表 1 不同ABSI患者临床资料比较
指标 低ASBI组(n=229) 中ASBI组(n=228) 高ASBI组(n=228) P值 男性[n(%)] 88(38.43) 122(53.51)* 174(76.32)*# ＜0.001 年龄(x±s，岁) 61.02±10.35 62.25±10.26 64.70±10.16* 0.001 吸烟史[n(%)] 43(18.78) 69(30.26) 93(40.79)* ＜0.001 饮酒史[n(%)] 28(12.23) 35(15.35) 54(23.68)* 0.003 血脂异常[n(%)] 42(18.34) 44(19.30) 47(20.61) 0.764 住院期间用药[n(%)] 血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂 40(17.47) 40(17.47) 41(17.98) 0.988 β受体阻滞剂 31(13.54) 39(17.11) 33(14.47) 0.542 钙通道阻滞剂 46(20.09) 51(22.37) 49(21.49) 0.835 他汀类药物 35(15.28) 32(14.04) 39(17.11) 0.660 ABSI：身体形态指数；*与低ASBI组比较，P均＜0.05；#与中ASBI组比较，P＜0.001 
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表 2 不同ABSI患者高血压靶器官损伤检出率比较[n(%)]
指标 低ASBI组(n=229) 中ASBI组(n=228) 高ASBI组(n=228) P值 左心室肥厚 29(12.66) 44(19.30) 63(27.63)* ＜0.001 颈动脉粥样硬化 59(25.76) 60(26.32) 89(39.04)*# 0.002 脑损伤 29(12.66) 30(13.16) 30(13.16) 0.984 肾功能损伤 6(2.62) 12(5.26) 32(14.04)*# ＜0.001 冠心病 87(37.99) 103(45.18) 102(44.74) 0.220 ABSI：同表 1；*与低ASBI组比较，P均＜0.05；#与中ASBI组比较，P均＜0.05
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表 3 ABSI与高血压患者靶器官损伤关联性的多因素Logistic回归分析结果
指标 分类变量(以低ABSI组为参照) 连续变量 中ABSI组[OR(95% CI)] 高ABSI组[OR(95% CI)] OR(95% CI) P值 左心室肥厚 1.52(0.91~2.56) 2.08(1.24~3.50)* 1.44(1.11~1.85) 0.006 颈动脉粥样硬化 0.83(0.54~1.29) 1.14(0.73~1.78) 1.08(0.86~1.35) 0.524 脑损伤 0.95(0.54~1.69) 0.72(0.39~1.32) 0.85(0.63~1.15) 0.288 肾功能损伤 2.15(0.79~5.87) 6.47(2.53~16.54)* 2.65(1.69~4.15) ＜0.001 冠心病 1.10(0.74~1.64) 0.73(0.48~1.11) 0.86(0.69~1.06) 0.145 ABSI：同表 1；*与低ASBI组比较，P均＜0.001
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