原发性高血压患者血压变异性与颈动脉硬化斑块的相关性分析

摘要

objective To explore the correlation between blood pressure variability (BPV) and carotid ath-erosclerotic plaques in patients with primary hypertension ,and to analyzes the relationship between isolated systolic hypertension ,isolated diastolic hypertension , systolic and diastolic hypertension and the incidence of carotid athero-sclerosis plaque .Methods A total of 110 patients with primary hypertension were selected and divided into 3 groups according to the type of hypertension:isolated systolic hypertension ( ISH) ( group A,n=35) isolated diastolic hyper-tension (group B,n=30),systolic and diastolic hypertension (group C,n=45) 30 healthy persons with normal blood pressure were recruited as control .The 24 h ambulatory blood pressure monitoring ( ABPM) were conducted among all the patients and healthy persons ,Carotid atherosclerosis was assessed by High resolution color doppler ultrasound .Re-sults The Parameters of blood pressure variation in hypertensive groups were significantly higher than that in normal group.The Parameters of systolic hypertension variation were higher than diastolic hypertension .The Parameters of blood pressure variation in group A was significant higher than that of other two groups .Parameters of primary hyper-tension group carotid scleros is plaques is significantly difference from the normal control group ,P<0.05.Conclusion The variation of blood pressure is correlated with carotid atherosclerosis plaque in patients with primary hyperten -sion.The incidence of carotid atherosclerosis plaque in patients with ISH is higher than that in patients with isolated diastolic hypertension and systolic and diastolichypertension .%目的探讨原发性高血压患者血压变异性（BPV）与颈动脉硬化斑块的相关性，并比较纯收缩期高血压、纯舒张期高血压、收缩期与舒张期双期高血压与颈动脉硬化斑块发生的关系。方法选择110例原发性高血压患者，根据血压升高类型不同分组，其中纯收缩期高血压（ISH）（A组）35例，纯舒张期高血压（B组）30例，收缩期与舒张期双期高血压（C组）45例，同期选择30例血压正常人作对比。均进行24h动态血压监测（24hABPM），同时应用高分辨率彩色多谱勒对其颈动脉行超声检查。结果高血压组血压变异各参数均显著大于正常组，昼夜变化规律四组一致，收缩压变异大于舒张压变异，白天血压变异大于夜间血压变异，A组血压变异各参数显著大于其他高血压组。高血压各组颈动脉硬化斑块参数与健康对照组比较差异有统计学意义，P＜0．05。结论原发性高血压患者血压变异性与颈动脉硬化斑块有明显的相关性，前者对后者有促进作用；纯收缩期高血压比纯舒张期、收缩期与舒张期双期高血压更易引起颈动脉硬化斑块。