老年高血压患者动脉僵硬度与血压变异性的关系

摘要

目的：探讨老年高血压患者动脉僵硬度与血压变异性（BPV）的关系。　　方法：选择老年高血压患者234例进行动脉僵硬度检测及24小时动态血压监测，以血压读数的标准差表示血压变异性，根据臂踝脉搏波传导速度（baPWV）实测值超过标准值的百分比分为动脉正常组（n=44）、动脉轻度硬化组（n=72）、动脉中度硬化组（n=78）、动脉重度硬化组（n=40），比较四组血压监测数据、血压变异性、血生化指标并分析与baPWV的相关性。　　结果：①四组患者高密度脂蛋白胆固醇、24小时平均舒张压、昼间平均舒张压、24小时平均收缩压及舒张压的标准差、昼间平均收缩压及舒张压的标准差、夜间平均舒张压的标准差比较，差异均有统计学意义（P均<0.05）。②baPWV增高的百分比与患者年龄、24小时收缩压的标准差、24小时舒张压的标准差、昼间收缩压的标准差、昼间及夜间舒张压的标准差呈正相关（r值分别为0.320、0.210、0.373、0.315、0.306和0.184；P均<0.01），与高密度脂蛋白胆固醇呈负相关（r=-0.178；P<0.01）。③患者年龄、24小时平均收缩压的标准差、24小时平均舒张压的标准差、昼间平均收缩压的标准差为baPWV的独立危险因素。　　结论：老年高血压患者动脉僵硬度与血压变异性密切相关。%Objective: To investigate the relationship between arterial stiffness and variability of blood pressure (BPV) in senile patients with hypertension. Methods: A total of 234 senile patients with hypertension were enrolled. The patients were examined by 24h ambulatory blood pressure monitoring (ABPM), BPV was identified by the standard deviation (SD) of blood pressure value. Based on increased percentage of baPWV, the patients were divided into 4 groups: Normal artery group, n=44, Mild arterial stiff group, n=72, Moderate arterial stiff group, n=78 and Severe arterial stiff group, n=40. The 24h ABPM results, BPV, biochemical indexes and their relationship to baPWV were compared among different groups. Results:①The HDL-C level and 24hDBP, dDBP, 24hSBPSD, 24hDBPSD, dSBPSD, dDBPSD, nDBPSD were significantly different among each group, all P<0.05.②The increased percentage of baPWV was positively related to the age and 24hSBPSD, 24hDBPSD, dSBPSD, dDBPSD, nDBPSD, while negatively related to HDL-C level, all P<0.05.③The age and 24hSBPSD, 24hDBPSD, dSBPSD were the independent risk factors for baPWV elevation. Conclusion: The arterial stiffness was closely related to BPV in senile patients with hypertension.