动态动脉硬化指数与原发性高血压患者血压昼夜节律的相关性研究

摘要

目的 分析动态动脉硬化指数(AASI)与原发性高血压患者血压昼夜节律的相关性.方法 选取2014年8月-2016年6月航空总医院收治的原发性高血压患者183例,根据AASI分为AASI≤0.49者46例(A组)、0.49＜ AASI≤0.53者46例(B组)、0.53＜ AASI≤0.56者45例(C组)及AASI＞0.56者46例(D组);根据血压昼夜节律分为杓型血压62例和非杓型血压121例.比较不同AASI患者一般资料、血脂指标、血压及血压昼夜节律指标,比较杓型血压和非杓型血压患者AASI,AASI与原发性高血压患者24h平均脉压、夜间血压下降率的相关性分析采用Pearson相关性分析.结果 不同AASI患者男性比例、年龄、三酰甘油、总胆固醇比较,差异无统计学意义(P＞0.05);不同AASI患者体质指数、日间收缩压、夜间收缩压、日间舒张压、夜间舒张压、24 h平均收缩压、24h平均舒张压及24 h平均脉压比较,差异有统计学意义(P＜0.05).C组和D组患者夜间收缩压下降率低于A、B组,D组患者夜间收缩压下降率低于C组(P＜0.05);D组患者夜间舒张压下降率低于A、B、C组(P＜0.05).非杓型血压患者AASI高于杓型血压患者(P＜0.01).Pearson相关性分析结果显示,AASI与原发性高血压患者24h平均脉压呈正相关(r =0.482,P＜0.001),与夜间收缩压下降率和夜间舒张压下降率呈负相关(r值分别为-0.436、-0.317,P＜0.001).结论 伴有血压昼夜节律异常的原发性高血压患者动脉粥样硬化程度较重,而AASI与原发性高血压患者血压昼夜节律有关.%Objective To analyze the correlation between ambulatory arterial stiffness index (AASI) and circadian rhythm of blood pressure in patients with essential hypertension.Methods A total of 183 patients with essential hypertension were selected in the Aviation General Hospital from August 2014 to June 2016,and they were divided into A group (with AASI equal or less than 0.49,n =46),B group (with AASI over 0.49 but equal or less than 0.53,n =46),C group (with AASI over 0.53 but equal or less than 0.56,n =45) and D group (with AASI over 0.56,n =46) according to AASI,into E group (with dipper type blood pressure,n =62) and F group (with non-dipper blood pressure,n =121) according to circadian rhythm of blood pressure.General information,blood lipids index,blood pressure and circadian rhythm of blood pressure related index were compared among A group,B group,C group and D group,meanwhile AASI was compared between E group and F group;correlations of AASI with 24-hour mean pulse pressure and nighttime blood pressure decreasing rate were analyzed by Pearson correlation analysis.Results No statistically significant differences of male ratio,age,TG or TC was found among A group,B group,C group and D group (P ＞ 0.05),while there were statistically significant differences of BMI,daytime systolic blood pressure,nighttime systolic blood pressure,daytime diastolic blood pressure,nighttime diastolic blood pressure,24-hour mean systolic blood pressure,24-hour mean diastolic blood pressure and 24-hour mean pulse pressure among A group,B group,C group and D group (P ＜ 0.05).Nighttime systolic blood pressure decreasing rate of C group and D group was statistically significantly lower than that of A group and B group,respectively,meanwhile nighttime systolic blood pressure decreasing rate of D group was statistically significantly lower than that of C group (P ＜ 0.05);nighttime diastolic blood pressure decreasing rate of D group was statistically significantly lower than that of A group,B group and C group,respectively (P ＜ 0.05).AASI of F group was statistically significantly higher than that of E group (P ＜ 0.01).Pearson correlation analysis results showed that,AASI was positively correlated with 24-hour mean pulse pressure (r =0.482,P ＜ 0.001),was negatively correlated with nighttime systolic blood pressure decreasing rate (r =-0.436) and nighttime diastolic blood pressure decreasing rate (r =-0.317) in patients with essential hypertension,respectively (P ＜ 0.001).Conclusion Atherosclerosis severity is more severe in essential hypertension patients with abnormal circadian rhythm of blood pressure,while AASI is closely correlated with the abnormal circadian rhythm of blood pressure in patients with essential hypertension.