我国北方人群血压盐敏感性的分布频率及其相关影响因素

摘要

Objective To survey the distribution frequency of salt sensitivity of blood pressure (SSBP) and relevant influence factors in population of north China.Methods The cluster radom sampling method was used to choose 1821 cases as subjects from Beijing and a city in Liaoning Province, and relevant data was collected through questionnaire, physical examination, biochemical index detection, time-point and 24 h detection of urinary sodium and potassium. SSBP was reviewed by using modified Sullivan's acute oral saline load and diuresis shrinkage test (MSAOSL-DST). The influence factors on SSBP were analyzed by using multi-factor Logistic regression analysis. Results Of 1778 cases received MSAOSL-DST, 541 (30.4%) with SSBP were detected. The detection rate of SSBP was 33.2% in patients with primary hypertension, 28.5% in population with normal blood pressure, and was higher in male cases than that in female cases (34.3%vs. 29.1%). The detection rate of SSBP was higher in diabetic patients than that in non-diabetic patients (37.1%vs. 29.2%, allP<0.05). The results of subgroup analysis showed that detection rate of SSBP was significantly higher in female, aged over 60, obesity and non-smoking patients with primary hypertension and non-diabetic subgroup than that in cases with normal blood pressure (allP<0.05). The waist hip ratio (WHR), fasting plasma glucose (FPG), smoking rate and prevalence of hypertension and diabetes were significantly higher, and level of triglyceride (TG) was lower in SSBP group than those in non-SSBP group (allP<0.05). The results of multi-factor Logistic regression analysis showed that smoking (OR=1.468, 95%CI: 1.075~2.006), hypertension (OR=1.330, 95%CI: 1.054~1.678), diabetes (OR=1.793, 95%CI: 1.189~2.716) and TG (OR=0.902, 95%CI: 0.834~0.976) were influence factors on SSBP.Conclusion The distribution frequency of SSBP is 30.4% in 2 cities in north China, and smoking, hypertension, diabetes and TG are influence factors on SSBP.%目的 调查中国北方人群血压盐敏感性的分布频率,探究其相关影响因素.方法 采用整群随机抽样方法 ,选取北京市和辽宁某城市1821例研究对象,通过问卷调查、体格检查、生化指标检测、时点和24 h尿钠钾检测等方法 收集相关信息.采用改良Sullivan急性口服盐水负荷及呋塞米排钠缩容试验进行盐敏感性判定.多因素Logistic回归分析血压盐敏感性的影响因素.结果 在1778例完成急性口服盐水负荷试验的研究对象中共检出盐敏感者541例(30.4%).原发性高血压患者血压盐敏感检出率为33.2%,高于血压正常者的28.5%;男性血压盐敏感检出率高于女性(34.3%vs.29.1%);糖尿病患者血压盐敏感检出率高于非糖尿病者(37.1%vs.29.2%),差异具有统计学意义(P均<0.05).亚组分析结果 显示,女性、60岁以上、肥胖、不吸烟和无糖尿病亚组的原发性高血压患者血压盐敏感检出率显著高于血压正常者,差异有统计学意义(P均<0.05).盐敏感组的腰臀比、空腹血糖、吸烟率、高血压和糖尿病患病率均显著高于非盐敏感组,而三酰甘油水平低于非盐敏感组,差异具有统计学意义(P均<0.05).多因素Logistic回归分析显示,吸烟(OR=1.468,95%CI:1.075~2.006)、高血压(OR=1.330,95%CI:1.054~1.678)、糖尿病(OR=1.793,95%CI:1.189~2.716)、三酰甘油(OR=0.902,95%CI:0.834~0.976)是血压盐敏感性的影响因素.结论 我国北方两城市血压盐敏感频率为30.4%,吸烟、高血压、糖尿病、三酰甘油为血压盐敏感性的影响因素.