不同海拔地区藏族就诊人群血脂、血液黏度、HCY水平与心血管疾病的相关性研究

目的:探讨不同海拔地区藏族就诊人群血脂、血液黏度、HCY水平与心血管疾病的相关性。方法:采用回顾性分析的方法,将328例来自不同海拔地区的藏族就诊患者为三组,高海拔组(纳入99例),中海拔(纳入120例)和低海拔组(纳入109例),比较不同海拔高度组患者血压、血脂、血液黏度、HCY、疾病类型的差异,采用多元Logistic回归模型分析藏族就诊人群心血管疾病发病的影响因素。结果:不同海拔组收缩压、舒张压、血清HCY、TC、TG、HDL-C、LDL-C水平、全血黏度低切、中切、高切、血浆黏度和红细胞压积比较差异均有统计学意义(P0.05),随着海拔升高,收缩压、舒张压、血清HCY、TC、TG以及LDL-C、全血黏度低切、中切、高切、血浆黏度和红细胞压积水平显著升高(P0.05),而血清HDL-C水平显著下降。41.8%(137/328)的就诊者至少患有一种心血管疾病,和非心血管组比较,心血管疾病组年龄明显偏高,居住主要分布在中度及高度海拔地区,合并高血糖、高血脂、高HCY的比例均明显较高,差异均有统计学意义(P0.05)。年龄、海拔、高血糖、高血脂、高HCY均和心血管疾病相关(r=-0.230~0.334,P0.05)。多元Logistic回归分析显示年龄、居住地海拔、HCY水平、全血低切粘度、TG水平、LDL-C等因素是心血管疾病发生的危险因素,HDL-C是保护因素。结论:来自不同海拔地区的就诊人群在血压、血脂、血液黏度、HCY水平以及心血管疾病患者占比不同。年龄、居住地海拔、HCY水平、血液黏度、血脂水平等增加可能使高原藏族人群心血管疾病发生风险增加。

Relationship between Blood Lipids, Blood Viscosity, HCY and Cardiovascular Disease in Tibetan Patients at Different Altitudes

ABSTRACT Objective: To explore the relationship between blood lipids, blood viscosity, HCY and cardiovascular disease in Tibetan population at different altitudes. Methods: Using a retrospective method, 328 Tibetan patients from different altitudes were carried out into three groups, high altitude group (99 cases), middle altitude (120 cases) and low altitude group (109 cases). The influence of altitude on blood pressure, blood lipid, blood viscosity, HCY and disease type were analyzed. Logistic regression model was used to analyze the risk factors of cardiovascular disease among Tibetan patients. Results: There were significant differences in systolic and diastolic pressure, serum HCY, TC, TG, HDL-C, LDL-C, whole blood low cut, middle cut, high cut , plasma viscosity and hematocrit between the three groups (P<0.05). With the increasing of altitude, systolic pressure, diastolic pressure, serum HCY, TC, TG and LDL-C, low viscosity of whole blood, medium cut, high cut, plasma viscosity and hematocrit increased significantly(P<0.05), but the serum HDL-C level decreased significantly. 41.8 % (137/328) patients had at least one kind of cardiovascular disease. Compared with the non-cardiovascular group, the age was significantly higher, the residence was mainly in the middle and high altitude areas, and the proportion of hyperglycemia, hyperlipidemia and high HCY was significantly longer (P<0.05). Age, altitude, hyperglycemia, hyperlipidemia, and high HCY were all associated with cardiovascular disease (r=-0.230~0.334, P<0.05). Multivariate Logistic regression analysis showed that age, residence altitude, HCY level, whole blood low shear viscosity, TG level, LDL-C and other factors were risk factors for cardiovascular disease, and HDL-C was a protective factor. Conclusion: The proportion of blood pressure, blood lipid, blood viscosity, HCY level and the proportion of patients with cardiovascular disease was different to those from different elevations. The increase of age, residence altitude, HCY level, blood viscosity and blood lipid level may increase the risk of cardiovascular disease in Tibetan plateau population.