原发性高血压患者晨间血压升高的相关因素分析

摘要

目的 探讨原发性高血压(EH)患者晨间血压升高的相关因素.方法 对201例EH患者进行血压监测并记录晨峰(睡-谷晨峰值>10 mmHg)发生情况,比较发生晨峰者和未发生者一般资料及血脂、空腹血糖(FBG)、胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)、纤维蛋白原(FIB)水平,对睡-谷晨峰值与上述指标的关系行Pearson相关分析.结果 59例血压出现晨峰现象(晨峰组),余142例未出现(非晨峰组);两组一般资料及血脂均无显著差异;晨峰组FBG、INS、FIB、HOMA-IR均显著高于非晨峰组(P均＜0.05);晨峰组睡-谷晨峰值与FBG、INS、FIB、HOMA-IR均呈现正相关.结论 高血糖、胰岛素抵抗、高胰岛素血症及血液高凝状态等与EH患者晨间血压升高有关.%Objective To investigate the related factors of morning surge hypertension in patients with essential hypertension(EH). Methods The blood pressure of 201 patients with EH were monitored and the morning blood pressure surge ( sleep-trough morning surge variability ＞ 10 mmHg )were recorded, patients with morning surge group or not were compared in the general information and the levels of blood fat, fasting blood glucose( FBG), insulin( INS), body mass index (BMI) insulin resistance index (HOMA-IR), fibrinogen. The correlation between sleep-trough morning surge variability and above indexes were analyzed. Results Fifty-nine patients showed morning blood pressure surge( MBPS group), and the other 142 patients were not found( NMBPS group); no difference were found between the two groups in the general information and blood fat; FBG, INS, FIB, HOMA-IR in the MBPS group were significantly higher than those in the NMBPS group ( all P ＜ 0.05 ); sleep-trough morning surge variability was positively correlated with FBG, INS, FIB, HOMA-IR.Conclusions Morning surge hypertension is closely related with high blood glucose, insulin-resistance, hyperinsulinemia and blood high coagulation.