颈动脉斑块形成与血压变异性的关系

摘要

Objective To investigate the relationship between carotid plaque formation and blood pressure variability (BPV) among the patients with high risk factors of cardio-cerebrovascular disease by 24 h ambulatory blood pressure monitoring.Methods The data on 102 hospitalized patients who had undergone carotid color ultrasound examination and 24 h ambulatory blood pressure monitoring during the period of June 2008 to May 2010 were collected.The patients were divided into ca-otid plaque formation group (68 patients) and non-carotid plaque formation group (34 patients).Univariate and multivariate analyses were used to identify the relationship between carotid plaque formation and parameters of ambulatory blood pressure monitoring including mean blood pressure,pulse pressure difference (PPD) and BPV,and other common risk factors.Results Age was older and 24 h BPVSBP,PPD and daytime BPVSBP were significantly higher in the patients with carotid plaque formation than in those without carotid plaque formation (t =5.302,P =0.000; t =3.664,P =0.000; t =4.503,P =0.000; and t =2.854,P =0.005,respectively).Binary logistic regression showed that age (OR =1.075,P=0.004),24 h BPVSBP (OR =1.0E + 30,P=0.001),and PPD (OR =1.111,P =0.002) were risk factors of carotid plaque formation.Conclusion Carotid plaque formation is mainly affected by age,PPD and BPV,and BPVSBP is one of the key risk factors.%目的:以24 h动态血压研究有心脑血管疾病高危因素患者的血压变异性(BPV)与颈动脉斑块形成之间的关系.方法:收集2008年1月至2010年5月住我院查颈彩超及24 h动态血压的患者102例,分为有斑块组(68例)及无斑块组(34例).以单因素及多因素方法分析平均血压、脉压差(PPD)及BPV等动态血压参数及其他常见危险因素与颈动脉斑块形成之间的关系.结果:有斑块组患者的年龄(t=5.302,P=0.000)、24 h收缩压的变异性(BPVSBP)(t=3.664,P=0.000)、PPD(t=4.503,P=0.000)及白昼的BPVSBP(t=2.854,P=0.005)均高于无斑块组；二项分类Logistic回归发现患者的年龄(OR=1.075,P=0.004)、24 h BPVSBP(OR=1.0E+ 30,P=0.001)及PPD(OR=1.111,P=0.002)是影响颈动脉斑块形成的危险因素.结论:颈动脉斑块形成主要受年龄、PPD及BPV影响,其中BPVSBP是关键危险因素之一.