Analysis of risk factors for essential hypertension complicated with cerebral infarction
LI Qi-guang1 CHEN Pei-song2 LIANG Ya-ru1 ZHONG Guo-quan1
1.Department of Clinical Laboratory,the Sixth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Qingyuan 511518,China;
2.Department of Clinical Laboratory,the First Affiliated Hospital of Sun Yat-sen University,Guangdong Province,Guangzhou 510630,China
Abstract：Objective To explore the risk factors of the occurrence of essential hypertension complicated with cerebral infarction.Methods A total of 377 hospitalized patientswith primary diagnosis of essential hypertension who were admitted to the Department of Neurology in the First Affiliated Hospital of Sun Yat-sen University from January 2016to July 2018 were selected in the study.They were divided into hypertensive complicated cerebral infarction group(114cases)and simple hypertensive group (263cases)according to whether they were complicated with cerebral infarction.Another 109 caseswith normal physical examination during the same period were selected as the healthy control group.Univariate analysis was used to analyze general clinical data such as systolic blood pressure,diastolic blood pressure,and coronary heart disease proportion of all researchers aswell as urea nitrogen(BUN),alkaline phosphatase(ALP),homocysteine(Hcy),white blood cell count(WBC),platelet count(PLT),fibrinogen(Fbg),high-sensitivity C-reactive protein(hs-CRP)and D-dimer(D-D)and other laboratory indicators for evaluation.Bymultivariate analysis,the risk factors for hypertension complicated with cerebral infarction were determined.Results Univariate analysis showed that systolic blood pressure,diastolic blood pressure,the proportion of coronary heart disease,and the levels of BUN,ALP,Hcy,WBC,Fbg,hs-CRP and D-D in the hypertensive complicated cerebral infarction group were higher than those in the simple hypertension group and healthy control group,while the level of PLT was lower than that in the simple hypertension group and healthy control group,the differenceswere statistically significant(P＜0.05).Multivariate analysis results showed that ALP(β=0.61,OR=1.88,95%CI:1.38-2.61),Hcy(β=0.37,OR=1.62,95%CI:1.17-2.25),Fbg(β=0.53,OR=1.85,95%CI:1.35-2.52)were risk factors for hypertension complicated with cerebral infarction (P＜0.05).Conclusion ALP,Hcy and Fbg are the risk factors for hypertension complicated with cerebral infarction,which are important for clinical evaluation of cerebral infarction.
Kabootari M，Raee MR，Akbarpour S，et al.Serum alkaline phosphatase and the risk of coronary heart disease，stroke and all-causemortality：Tehran Lipid and Glucose Study[J].BMJOpen，2018，8（11）：e023735.
[10]
SchutteR，Huisman HW，Malan L，etal.Alkaline phosphatase and arterial structure and function in hypertensive African men：the SABPA study[J].Int JCardiol，2013，167（5）：1995-2001.
[11]
Li JW，Xu C，Fan Y，et al.Can serum levels of alkaline phosphatase and phosphate predict cardiovascular diseases and total mortality in individuals with preserved renal function?A systemic review and meta-analysis[J].PLoS One，2014，9（7）：e102276.
[13]
Schoppet M，Shanahan CM.Role for alkaline phosphatase as an inducer of vascular calcification in renal failure?[J].Kidney Int，2008，73（9）：989-991.
[14]
Natarajan P，Jaiswal S，Kathiresan S.Clonal hematopoiesis：somatic mutations in blood cells and atherosclrosis[J].Circ Genom Precis Med，2018，11（7）：e001926.
[15]
Cheung BM，Ong KL，Wong LY.Elevated serum alkaline phosphatase and peripheral arterial disease in the United States National Health and Nutrition Examination Survey 1999-2004[J].Int JCardiol，2009，135（2）：156-161.
Tinelli C，Di Pino A，Ficulle E，et al.Hyperhomocysteinemia as a risk factor and potential nutraceutical target for certain pathologies[J].Front Nutr，2019，6：49.
Wang Y，Li Z，Zhao X，et al.Stroke care quality in China：Substantial improvement，and a huge challenge and opportunity[J].Int JStroke，2017，12（3）：229-235.
[17]
Behera J，Tyaqi SC，Tyaqi N.Hyperhomocysteinemia induced endothelial progenitor cells dysfunction through hypermethylation of CBS promoter[J].Biochem Biophys Res Commun，2019，510（1）：135-141.
[18]
Liu X，Qin Z，Liu C，et al.Nox4and soluble epoxide hydrolase synergistically mediate homocysteine-induced inflammation in vascular smooth muscle cells[J].Vascul Pharmacol，2019，120：106544.
[19]
Baszczuk A，Kopczynski Z，Thielemann A.Endothelial dysfunction in patients with primary hypertension and hyperhomocysteinemia[J].Postepy HigMed Dosw（Online），2014，68：91-100.[20]Van Dijk AC，Donkel SJ，Zadi T，et al.Association between fibrinogen and fibrinogenγ′and atherosclerotic plaque morphology and composition in symptomatic carotid artery stenosis：plaque-at risk study[J].Thromb Res，2019，177：130-135.
[21]
Li X，An B，Zhao Q，et al.Combined fibrinogen and neutrophil-lymphocyte ratio as a predictive factor in resectable colorectal adenocarcinoma[J].Cancer Manaq Res，2018，10：6285-6294.
[22]
Catena C，Colussi G，Novello M，et al.Intrarenal vascular resistance is associated with a prothrombotic state in hypertensive patients[J].Kidney Blood Press Res，2016，41（6）：929-936.
[23]
Ozcan Cetin EH，Konte HC，Temizhan A.Blood viscosity should notbe overlooked when evaluating the fibrinogen to albumin ratio[J].Anqiology，2019，70（5）：465-466.
[24]
Lallukka S，Luukkonen PK，Zhou Y，et al.Obesity/insulin resistance rather than liver fat increases coagulation factor activities and rxpression in humans[J].Thromb Haemost，2017，117（2）：286-294.
京公网安备 11010502046607号