原发性高血压患者血压变异性与颈动脉粥样硬化的关系

摘要

Objective To investigate the relationship between blood pressure variability and carotid atherosclerosis in patients with primary hypertension. Methods 220 patients with primary hypertension from April 2013 to December 2014 in the Fifth People's Hospital of Chengdu City were selected, according to the results of carotid ultrasound exami-nation, they were divided into carotid atherosclerosis group (143 cases) and pure hypertensive group (77 cases); and patients of the carotid atherosclerosis group were further divided into low BPV group (81 cases) and high BPV group (62 cases) based on ambulatory blood pressure monitoring. Ambulatory blood pressure, blood pressure variability and carotid artery ultrasound results of each group were analyzed. Results 24hSBP, 24hDBP, dSBP, nSBP, 24hSCV, IMT between pure hypertensive group and carotid atherosclerosis group had statistically significant differences (P<0.05). High BPV group on the right and the left common carotid artery, the right and left external carotid artery IMT and carotid artery plaque average detection rate were significantly higher than the low BPV group (P<0.05). 24hSBP, dSBP, nSBP, 24hSCV, 24hDCV were positively correlated with average IMT (r=0.425, 0.436, 0419, 0.354, 0.315, all P< 0.05). Mul-tiple linear regression analysis showed that, 24hSCV, 24hDCV, 24hSBP with carotid IMT were independently associat-ed (P<0.05), 24hSCV, 24hSBP and independently associated with carotid plaque (P<0.05). Conclusion Blood pres-sure variability is closely related to carotid IMT and carotid artery plaque, which 24hSCV, 24hDCV, 24hSBP are inde-pendently associated factors of carotid IMT, 24hSCV, 24hSBP are independently associated factors of carotid plaque.%目的：探讨原发性高血压患者血压变异性与颈动脉粥样硬化的关系。方法选取2013年4月~2014年12月于成都市第五人民医院住院治疗的原发性高血压患者220例,根据颈动脉超声检查结果将其分为颈动脉硬化组(143例)和单纯高血压组(77例),根据动态血压监测结果将颈动脉硬化组分为低血压变异性(BPV)组(81例)和高BPV组(62例)。分析各组患者动态血压、血压变异性及颈动脉超声结果。结果单纯高血压组和颈动脉硬化组24 h平均收缩压(24hSBP)、24 h平均舒张压(24hDBP)、昼间平均收缩压(dSBP)、夜间平均收缩压(nSBP)、24 h收缩压变异系数(24hSCV)、颈动脉内膜中层厚度(IMT)比较,差异均有统计学意义(P<0.05)。高BPV组右侧和左侧颈总动脉、右侧和左侧颈外动脉、平均IMT及颈动脉斑块检出率均明显高于低BPV组(P<0.05)。24hSBP、dSBP、nSBP、24hSCV、24h舒张压变异系数(24hDCV)与平均IMT均呈正相关(r=0.425、0.436、0419、0.354、0.315,均 P <0.05)。多元线性回归分析结果显示,24hSCV、24hDCV、24hSBP与颈动脉 IMT独立相关(P <0.05),24hSCV、24hSBP与颈动脉斑块独立相关(P<0.05)。结论血压变异性与颈动脉IMT及颈动脉斑块密切相关,其中24hSCV、24hDCV、24hSBP是颈动脉IMT的独立相关因素,24hSCV、24hSBP是颈动脉斑块独立相关因素。