高胆固醇血症患者内皮功能与血压变异时率的相关性分析

摘要

Objective To review the correlation between endothelial function and time rate of blood pressure variability (BPV) in patients with hypercholesteremia.Methods The patients (n=46, male 17, female 29 and average age=61.80±8.96) were continuously chosen from the Department of Cardiology of Jingxi Hospital from Jun. 2015 to Dec. 2015. All patients were given 24-h ambulatory blood pressure monitoring (ABPM) for reviewing blood pressure (BP) and calculating BPV time rate including 24-h, daytime and nighttime BPV time rate. The endothelial function was reviewed by using EndoPAT 2000 detector [denoted with reactive hyperemia index (RHI)], and then all patients were divided into low endothelial function group (RHI≤1.67,n=12) and normal endothelial function group (RHI>1.67,n=34).Results The average BP was 123/74 mmHg and RHI was 2.07 in 46 patients, and BPV time rate of systolic blood pressure (SBP) was higher than that of diastolic blood pressure (SBP). The daytime, 24-h and nighttime average BPV time rates showed a descending trend (allP<0.05). The age was higher, and 24-h average DBP and nighttime BPV time rate of DBP were lower in low endothelial function group than those in normal endothelial function group (allP<0.05). RHI decreased respectively 0.25 and 0.20 when 24-h and daytime BPV time rate of SBP increased each 0.1 mmHg/min (allP<0.05) after regulating sex, age, diabetes, hypertension and drug taking.Conclusion There is a negative correlation between 24-h and daytime BPV time rate of SBP and endothelial function in patients with hypercholesteremia.%目的 评估高脂血症患者内皮功能与血压变异时率的相关性.方法 从2015年6月~12月连续入组京西医院心内科门诊的高胆固醇血症患者46例,其中男性17例,女性29例,平均年龄(61.80±8.96)岁.进行24 h动态血压监测(ABPM)评估血压及计算血压随着时间的变化速度(血压变异时率),包括24 h、日间及夜间的血压变异时率;并通过内皮功能检测仪(EndoPAT 2000)评估内皮功能(以反应性充血指数RHI来表示),RHI≤1.67和RHI>1.67将研究对象分成内皮功能减低组(12例)和内皮功能正常组(34例),比较两组患者临床资料,并通过多元线性回归分析内皮功能与血压变异时率的相关性.结果 46例高脂血症患者平均血压为123/74 mmHg(1 mmHg=0.133kPa),RHI为2.07,收缩压的血压变异时率均高于舒张压,日间平均血压变异时率、24 h血压变异时率、夜间平均血压变异时率呈降低趋势,差异有统计学意义(P均<0.05).内皮功能减低组患者年龄明显高于内皮功能正常组,而24 h平均舒张期(DBP)、夜间DBP变异时率低于内皮功能正常组,差异有统计学意义(P均<0.05).调整性别、年龄、糖尿病、高血压及服用药物情况后,24 h收缩期(SBP)变异时率、日间SBP变异时率每增加0.1 mmHg/min,RHI分别降低0.25和0.20(P均<0.05).结论 高胆固醇血症患者24 h及日间收缩压变异时率与内皮功能指标呈负相关.