鼻出血与高血压之间的关系：对尼日利亚两家三级医疗机构急诊科就诊患者的研究。

Relationship between epistaxis and hypertension: a study of patients seen in the emergency units of two tertiary health institutions in Nigeria.

作者信息

Isezuo S A, Segun-Busari S, Ezunu E, Yakubu A, Iseh K, Legbo J, Alabi B S, Dunmade A E, Ologe F E

机构信息

Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

出版信息

Niger J Clin Pract. 2008 Dec;11(4):379-82.

PMID:19320416

Abstract

BACKGROUND

Both epistaxis and hypertension are common in the general population.

OBJECTIVE

This study aimed at determining the prevalence of hypertension among epistaxics, and the relationship between epistaxis and hypertension.

METHODS

Retrospective analysis of 62 adults comprising 31 each of males and females with a mean age of 41.4 +/- 16.6 years (range: 18-90 years) that presented in the emergency units of two tertiary health institutions seen over 11 years was done. Main outcome measure was the prevalence of hypertension amongst epistaxics. Seventy-six age and sex-matched patients with bleeding from sites other than the nostrils with no record of epistaxis were selected by simple random sampling as controls.

RESULTS

Peak prevalence of epistaxis occurred during the months of January and March. Compared to the controls, the epistaxics had significantly higher blood pressures: (146.1 +/- 40.7 mmHg versus 123.2 +/- 16.3 mmHg systolic, P=0.001), and (91.3 +/- 24.8 mmHg versus 78.2 +/- 12.8 mmHg diastolic, P=0.001), and higher proportions of patients with previous history of hypertension (32.3% versus 7.9%; p<0.001) and family history of hypertension (12.9% versus 2.6%; p<0.02). The proportion of subjects with blood pressure elevation at presentation that remained sustained was significantly higher among the epistaxics than the nonepistaxics (87.5% versus 47.6%, chi2=8.1, P=0.005). The epistaxics had significantly higher prevalence of hypertension than the non-epistaxics (45.2% versus 13.2%, chi2=17.5, p=0.001). Univariate analysis demonstrated association between epistaxis and hypertension (OR=5.4, 95% CI=2.4-12.5, P=0.001), and between epistaxis and age (OR=0.9, 95% CI=1.3-12.5, P=0.02). On multivariate analysis using logistic regression the association between epistaxis and hypertension persisted, after adjusting for age, sex, season and causes of epistaxis (OR=5.6, 95% CI=1.7-15.6, P=0.01).

CONCLUSIONS

Our findings support an association between epistaxis and hypertension in the study population.

摘要

背景

鼻出血和高血压在普通人群中都很常见。

目的

本研究旨在确定鼻出血患者中高血压的患病率，以及鼻出血与高血压之间的关系。

方法

对两家三级医疗机构急诊科11年间收治的62例成年人进行回顾性分析，其中男性和女性各31例，平均年龄41.4±16.6岁（范围：18 - 90岁）。主要观察指标是鼻出血患者中高血压的患病率。通过简单随机抽样选择76例年龄和性别匹配的非鼻孔部位出血且无鼻出血记录的患者作为对照。

结果

鼻出血的高发期出现在1月和3月。与对照组相比，鼻出血患者的血压显著更高：收缩压（146.1±40.7 mmHg对123.2±16.3 mmHg，P = 0.001），舒张压（91.3±24.8 mmHg对78.2±12.8 mmHg，P = 0.001），有高血压既往史的患者比例更高（32.3%对7.9%；p < 0.001），有高血压家族史的患者比例更高（12.9%对2.6%；p < 0.02）。鼻出血患者中就诊时血压升高且持续的比例显著高于非鼻出血患者（87.5%对47.6%，χ2 = 8.1，P = 0.005）。鼻出血患者的高血压患病率显著高于非鼻出血患者（45.2%对13.2%，χ2 = 17.5，p = 0.001）。单因素分析表明鼻出血与高血压之间存在关联（OR = 5.4，95%CI = 2.4 - 12.5，P = 0.001），鼻出血与年龄之间也存在关联（OR = 0.9，95%CI = 1.3 - 12.5，P = 0.02）。在使用逻辑回归进行多因素分析时，在调整年龄、性别、季节和鼻出血原因后，鼻出血与高血压之间的关联仍然存在（OR = 5.6，95%CI = 1.7 - 15.6，P = 0.01）。