Nghiên cứu tổn thương một số cơ quan ở bệnh nhân tăng huyết áp nguyên phát có hội chứng chuyển hóa tại bệnh viện đa khoa khu vực tỉnh Phú Thọ

NGHIEN CUU TdN THimNG MOT SO Cff QUAt\l

or BENH NHAN TANG HUYET AP NGUYEN PHAT CO HOI CHUUG CHU.

TAI BENH VIEN DA KHOA KHU VURC TINH PHU THO

L £ QUOC TUA'N, TRjNH XUA N TRANG

Trudng Bai hpc Y du^ Thii Nguyin

NGUYEN THI THU HIEN - Trudng Cao ddng Y tiPhii Tho

TOM TA T

Mdt so nghidn ciiu gin diy cho thiy cd su tdng ti 1$

tin thuang cic ca quan dich nhu: thin, nao vi tim d

binh nhin ting huyit ip (THA) nguydn phat cd hdi

chi»ig chuyin hda (HCCH).

Tmng nghidn cdu niy, 341 bdnh nhin THA nguydn

phat (nam 170, nH 171) dugc lam didn tim, do vdng

bung, glucose, HDL-c. TG. creatinin miu luc ddi vi

protein nidu. Nhdm THA cd HCCH dupc chin ddn

theo tiiu chuin cOa Lidn ddn Dii th$o dudng Quic ti

(IDF: Intemational Diabetes Federation) ip dpng cho

khu vuc chiu A-Thii Binh Duang (2<X}5). Kit qui cda

nghidn ciiu cho thiy:

Thi cd tin thuang nio d nhdm cd HCCH (59,4%)

cao han so vdi nhdm khdng d HCCH (8,8%) vdi

p<0.001; OR = 15,2 (Cl: 8.3-28,1).

Thi tin thuang thin d nhdm cd HCCH (49,4%)

cao hdn so v& nhdm khdng cd HCCH (34,5%) vdi

p<0,001;OR= 1.9(CI: 1,2-2,9).

Tile tin thuang tim d nhdm cd HCCH (49,4%) cao

han so vdi nhdm khdng d HCCH (29,2%) vdip<0,001;

OR =2,4 (01:1,5-3,7).

Tdm lai: cd sugia ting tin thuang than, nao vi tim

d binh nhin THA nguydn phit cd HCCH.

TCrkhda: ting huyit ip, hdi chiing chuyin hda.

SUMMARY

Backgrouds: Some previous studies showed that

there was a high prevalence of rate some organs

impairment such as hdney, brain and heart in

hypertensh/e pab'ents with metatioiic syndome (MS).

Methods and Results: In this study, 341

hypertensive patients (male: 170; female: 171) were

tested electrocardiography and meassured waist

dmumkrence, fasting glucose, HDL-c, TG, creatinin

and proteinuria. The MS group was diagnosed by

Mema^rmal Diabetes Federation (IDF) criteria for

f^cific region. The results as below:

• Prevalence brain impairment rate of hypertensive

MS group (59.4%) was higher than that non-MS group

(6.8) and there was abvious difference between them

(p < 0,001); OR = 15.2 (Cl: 8.3-28.1).

- PfBvafence kidney impairment rate of

hyperiensive MS group (49.4%) was higher than that

non-MS group (34.5) and there was abvious difference

between them (p < 0,001); OR = 1.9 (Cl: 1.2-2.9).

- Prevalence heart impairment rate of hypertensive

MS group (49.4%) was higher than that non-MS group

(29.2) and there was abvious difference between them

ip < 0,001); OR = 2.4 (Cl: 1.5-3.7).

Ckmdusions: There was a high risks for develof^ng

ladney, brain and heart impairdment in hypertenme

patients with MS.

Keywords: hypertension, Metabolic syndrome.

DAT VAN DE

Ngay nay, tdng huydt dp (THA) nguyen phat co xu

hudng tang nhanh trdn pham vi toan the gidi (WHO

thdng kd d Viet Nam (2008) thi Ei le THA nguyen phat

chidm 26,1%). THA thudng gay ra cac bien ctidng

ndng nd nhu tdn thUdng than, nao, tim mach... tam

tang nguy cd tdvong va tan phd cho ngudi bi benh (1],

Ddng thdi, sUgia ISng nhanh chdng hpi chUng chuyen

hod (HCCH' metabolic syndrome) dang la thach thdc

Idn trong cdng ddng b nhieu qudc gia cijng nhud Viet

Nam [10]. Bdi vi, theo mot sd nghien cUu gan day eho

thdy b ngudi THA cd HCCH thi nguy co bi tdn thUdng

eae cO quan dich cao hon nhieu so vdi benh nhan THA

don thuan, nhat la nguy ed mac benh tim mach vd Idm

tdng tl le td vong d ngUdi cd HCCH [7]. 6 Viet Nam, da

ed mot sd nghien edu vd tdn thuong co quan dich d

benh nhdn THA nguyen phdt [3], [4]. Tuy nhien, nghien

cdu tdn thUdng cd quan dich d benti nhan THA nguyen

phdt cd HCCH cdn chUa dUde quan tam, dae biet Id d

khu vuc cd kinh te, phdt tridn thap nhu mien nui trung

du tinh Phu Thp. Xudt phat td ly do do, ehung tdi

nghien edu de tdi nham muc tieu' Nghien citu tin

thuang mdt soca quan dich 6 bdnh nhan THA nguydn

phit cd HCCH den khim vi di4u tri tai Bdnh viin Da

khoa khu vuc tinh Phu Thp.

E)6l TUONG vA PHl/ONG PHAP NGHIEN CLTU

1. Doi tupng nghien cdu

Gdm 341 benh nhan (nam 170, nd 171) cd dp tudi

tatng binh 68,0 ±11,5 (ndm) dupe kham, didu tri tai

khoa Khdm benh, Benh vien Oa khoa Khu vuc tinh

Phd Thp td td thang 12/2011 ddn thdng 9/2012, Chia

Idm hai nhdm:

- Nhom cd HCCH theo tieu chuan IDF (2005).

- Nhom khdng cd HCCH.

2. Phuong phdp nghien cdu

2.1. Thiit ki nghiin cuiu: nghidn edu tidn edu, md

ta. cat ngang.

2.Z N^ dung nghiin cOu:

Cdc bdnh nhan nghien cdu duoe hdi ve tuoi. tien

sd. bdnh sd, cae YTNC, kham lam sdng todn dien vd

duOc ghi chep ddy dd vdo mdu bdnh an nghien cdU.

* Do huydt dp: theo khuydn edo cda Hdi Tim maeh

hoc Vidt Nam 2010 [1]. Chin doan THA nguyen phdt

theo tidu ehuan cda JNC VII (2003) khi: HATT > 140

mmHg vd/hoSc HATTr £ 90 mmHg hode dang dieu tri

THA [8].

* €)o vdng bung (VB) theo phuong phap do nhan

trie hpc [2]. Theo tieu chudn cda WHO dp dung cho

khu vuc chau A - Thai Binh Duong (2000) khi ddi tupng

Y HOC THUC HANH (843) - S610/2012