文章摘要
张娜玲,王小芳,冷少华,孙丽.维生素D联合降压治疗对老年原发性高血压患者的影响[J].中国临床保健杂志,2020,23(5):628-631.
维生素D联合降压治疗对老年原发性高血压患者的影响
Effects of vitamin D combined with antihypertensive therapy on blood pressur in elderly patients with essential hypertension
投稿时间:2020-04-28  
DOI:10.3969/J.issn.1672-6790.2020.05.013
中文关键词: 原发性高血压  维生素D  抗高血压药  老年人
英文关键词: Essential hypertension  Vitamin D  Antihypertensive agents  Aged 〖FL
基金项目:国家自然科学基金地区科学基金项目(31760327)
作者单位E-mail
张娜玲 中国人民解放军陆军军医大学第一附属医院健康管理中心,重庆 400038 51088031@qq.com 
王小芳 中国人民解放军陆军军医大学第一附属医院健康管理中心,重庆 400038 51088031@qq.com 
冷少华 中国人民解放军陆军军医大学第一附属医院健康管理中心,重庆 400038 51088031@qq.com 
孙丽 中国人民解放军陆军军医大学第一附属医院健康管理中心,重庆 400038 51088031@qq.com 
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中文摘要:
      目的 探讨维生素D联合降压治疗对老年原发性高血压患者血压、脂代谢、血管弹性及体质指数(BMI)的影响。方法 选取2017年1月至2019年8月解放军陆军军医大学第一附属医院收治的原发性高血压老年患者162例,分为维生素D缺乏组57例,维生素D不足组63例,维生素D充足组42例,收集患者临床资料进行单因素、相关性分析。根据患者治疗意愿将120例维生素D缺乏和不足患者分为观察组和对照组各60例,均常规降压治疗,在此基础上观察组给予骨化三醇软胶囊补充维生素D。治疗6个月后比较两组患者血压、血脂、血管弹性及体质指数(BMI)。结果 维生素D缺乏组、维生素D不足组、维生素D充足组的BMI、高血压分级、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、动脉弹性指数差异有统计学意义(χ2=11.555,P=0.003;χ2=13.948,P=0.007;F=6.703,P=0.002;F=11.575,P<0.001;F=13.164,P<0.001)。维生素D水平与BMI、收缩压、LDL-C水平呈负相关(r=-0.300,P<0.001;r=-0.639,P<0.001;r=-0.301,P<0.001),与HDL-C水平、动脉弹性指数呈正相关(r=0.189,P=0.016;r=0.359,P<0.001)。治疗后,观察组收缩压、舒张压、三酰甘油(TG)、总胆固醇(TC)、LDL-C、BMI均低于对照组(t=3.115,P=0.002;t=2.252,P=0.026;t=2.643,P=0.009;t=2.621,P=0.010;t=2.703,P=0.008;t=2.313,P=0.022),HDL-C、动脉弹性指数均高于对照组(t=2.987,P=0.003;t=2.737,P=0.007)。结论 老年原发性高血压患者的血压、血脂水平、血管弹性及BMI与维生素D水平密切相关,维生素D缺乏和不足的患者在降压治疗同时补充维生素D有助于降低血压、调节血脂、改善血管弹性、减轻体质量、增加临床获益。
英文摘要:
      Objective To explore effects of vitamin D combined with antihypertensive therapy on blood pressure,lipid metabolism,vascular elasticity and body mass index (BMI) in elderly patients with essential hypertension (EH).Methods A total of 162 elderly EH patients who were admitted to the hospital from January 2017 to August 2019 were enrolled.They were divided into vitamin D deficiency group (57 cases),vitamin D insufficiency group (63 cases) and vitamin D sufficiency group (42 cases).The clinical data of patients were collected for univariate and correlation analysis.According to their treatment willingness,120 patients with vitamin D deficiency and insufficiency were divided into observation group and control group,60 cases in each group,and all were treated with antihypertensive therapy.On this basis,observation group was given calcitriol soft capsules to supplement vitamin D.After 6 months of treatment,blood pressure,lipid metabolism,vascular elasticity and BMI were compared between the two groups.ResultsThere were significant differences in BMI,hypertension grading,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and arterial elasticity index among three groups (χ2=11.555,P=0.003;χ2=13.948,P=0.007;F=6.703,P=0.002;F=11.575,P<0.001;F=13.164,P<0.001).Vitamin D level was negatively correlated with BMI,systolic blood pressure and LDL-C level (r=-0.300,P<0.001;r=-0.639,P<0.001;r=-0.301,P<0.001),while positively correlated with HDL-C level and arterial elasticity index (r=0.189,P=0.016;r=0.359,P<0.001).After treatment,systolic blood pressure,diastolic blood pressure,triglyceride (TG),total cholesterol (TC),LDL-C and BMI in observation group were lower than those in control group (t=3.115,P=0.002;t=2.252,P=0.026;t=2.643,P=0.009;t=2.621,P=0.010;t=2.703,P=0.008;t=2.313,P=0.022),while HDL-C and arterial elasticity index were higher than those in control group (t=2.987,P=0.003;t=2.737,P=0.007).Conclusion For patients with vitamin D deficiency and insufficiency,supplementing vitamin D combined with antihypertensive treatment is conducive to lowe blood pressure,regulate blood lipid metabolism and vascular elasticity,lose weight.
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