摘要
目的探讨正常高值血压人群24h动态血压昼夜节律与臂踝脉搏波传导速度(baPWV)、颈动脉内膜中层厚度(IMT)的相关性。方法 2008-07-2009-07在山东省章丘市农村入选受试对象306例,其中理想血压组(<120/80mmHg)96例,正常高值血压人群210例。对所有入选对象进行24h动态血压监测(24hABPM)、baPWV及颈动脉IMT检测。将正常高值血压人群根据获取的24hABPM参数分为杓型组(92例)与非杓型组(118例),同时进行baPWV及颈动脉IMT检测。结果非杓型组24h收缩压(24hSBP)均值较杓型组升高[(123·6±8·5)比(119·6±9·5)mmHg,P<0·05],夜间血压各指标均较杓型组明显升高(P<0·01)。非杓型组baPWV[(1376·6±118·7)比(1311·9±114·2)cm/s,P<0·01]、IMT[(0·93±0·11)比(0·81±0·12)mm,P<0·05]均较杓型组升高。正常高值血压人群多元回归分析显示:三酰甘油、夜间收缩压下降率(SBPF)、夜间舒张压下降率(DBPF)、夜间收缩压均值(nSBP)是baPWV的影响因素,总胆固醇、SBPF、DBPF、24hSBP、nSBP是IMT的影响因素。结论正常高值血压人群已出现动脉粥样硬化及弹性功能的减退。异常昼夜节律与baPWV及IMT密切相关。
Objective To investigate the relationship between brachial-ankle pulse wave velocity（baPWV）, carotid intima-media thickness（IMT） and circadian rhythm of 24 hours ambulatory blood pressure monitoring （24hABPM） in prehypertensive subjects. Methods Three hundred and six cases in the rural area of Zhangqiu City, Shandong Province from July 2008 to July 2009 were recruited, including 96 subjects with normotension （120/80 mm Hg） and 210 ones with prehypertension. All the subjects underwent 24hABPM, baPWV and IMT detection, and the prehypertensive participants were subdivided into 2 groups based on 24hABPM results： 92 cases of dipper group and the other 118 ones of non-dipper group. Results The average 24 hours systolic blood pressure （24hSBP） was higher in non-dipper group than in dipper group[（123.55±8.46）vs（119.59±9.51）mm Hg,P0.05]. And a more marked increase of the nocturnal blood pressure parameters could be found in non-dipper group than that in dipper group. BaPWV and IMT in non-dipper group increased obviously than those in dipper group[（1376.65±118.74） vs （1311.92±114.21） cm/s, P0.01; （0.93±0.11） vs （0.81±0.12） mm, P0.05]. Triglyceride, systolic blood pressure fall（SBPF）, diastolic blood pressure fall（DBPF） and nocturnal systolic blood pressure （nSBP） were risk factors for baPWV, while total cholesterol, SBPF, DBPF, 24hSBP, daytime systolic blood pressure were risk factors for IMT by multiple regression analysis. Conclusion The prehypertensive subjects had emerged atherosclerosis and decreased aortic elasticity. BaPWV and IMT were closely related to the abnormal circadian rhythm of 24hABPM.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2011年第5期474-478,共5页
Chinese Journal of Hypertension
基金
山东省医药卫生科技发展计划资助项目(2009HW080)
山东省自然科学基金资助项目(ZR2009CL029)
山东省医学科学院资助项目2009(16)
(17)
关键词
正常高值血压
动态血压监测
臂踝脉搏波传导速度
颈动脉内膜中层厚度
Prehypertensive subjects
Ambulatory blood pressure monitoring
Brachial-ankle pulse wave velocity
Carotid intima media thickness
作者简介
通信作者：路方红，E-mail：fanghonglu1953@163．com
