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目的 探讨代谢综合征与酒精性脂肪肝对老年高血压患者脂代谢及颈动脉内膜-中层厚度的影响.方法 将90例老年高血压患者依据合并症不同进行分组,单纯高血压组30例,高血压合并代谢综合征组30例,高血压合并酒精性脂肪肝组30例.观察3组患者体质量指数、舒张压、收缩压、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、空腹血糖、颈动脉内膜-中层厚度情况.对高血压合并代谢综合征组和高血压合并酒精性脂肪肝组颈动脉内膜-中层厚度进行多因素Logistic回归分析.结果 高血压合并代谢综合征组及高血压合并酒精性脂肪肝组体质量指数、血清总胆固醇、甘油三酯、空腹血糖及颈动脉内膜-中层厚度均显著高于单纯高血压组(P＜0.05或0.01),高密度脂蛋白胆固醇显著低于单纯高血压组(P＜0.01).高血压合并代谢综合征组患者的体质量指数、收缩压及空腹血糖与颈动脉内膜-中层厚度有显著相关性(P＜0.05);高血压合并酒精性脂肪肝组患者的体质量指数、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇与颈动脉内膜-中层厚度有显著相关性(P＜0.05).结论 代谢综合征与酒精性脂肪肝均会增加老年高血压患者颈动脉内膜-中层厚度,增加了动脉粥样硬化的发生风险.“,”Objective To investigate the effects of MS and NAFLD on lipid metabolism and CAIMT in senile patients with hypertension. Methods 90 cases of senile patients with hypertension were divided into groups according to different complications, 30 cases in the simple hypertension group, 30 cases in the hypertension with MS group, and 30 cases in the hypertension with NAFLD group. The BMI, DBP,SBP, TC,TG,HDL-C, FPG,CAIMT of the three groups were observed. CAIMT in the hypertension with MS group and the hypertension with NAFLD group were given multiple Logistic aggression analysis. Results The BMI, TC,TG,FPG and CAIMT in the hypertension with MS group and the hypertension with NAFLD group were significantly higher than those in the simple hypertension group (P＜0.05 or 0.01), HDL-C was significantly lower than that in the simple hypertension group (P＜0.01). In the hypertension with MS group, the BMI, SBP, FPG had significant correlation with CAIMT (P＜0.05); in the hypertension with NAFLD group, the BMI, TC,TG,HDL-C had significant correlation with CAIMT (P＜0.05). Conclusion MS and NAFLD all can increase CAIMT of senile patients with hypertension, and increase the occurrence risk of atherosis.