基于血压变异性的评分系统与高血压患者靶器官损害的相关性

摘要

目的：探讨基于血压变异性的评分系统（BPVSS）与高血压患者靶器官损害的关系。方法连续选取2015年1～6月在广州军区广州总医院心内科住院的原发性高血压患者95例；比较各BPV指标与舒张期室间隔厚度（IVSd）、左室后壁厚度（LVPWd）、左/右侧肱踝脉搏波传导速度（baPWV_L/R）和左/右侧颈动脉内膜中层厚度（IMT_L/R）之间的Pearson相关性；按3.9对BPVSS进行量化分组，BPVSS≥3.9为对照组（43例），BPVSS<3.9为观察组（52例），并分析两组之间IVSd、LVPWd、baPWV、IMT及颈动脉斑块所占比的差异。结果 BPVSS和传统的BPV指标一样与IMT_L/R具有负相关性（r=-0.278/-0.324，P<0.05）；与IVSd、LVPWd、baPWV_L/R具有负相关性（r=-0.241，r=-0.223，r=-0.468/-0.373，P均<0.05）；观察组的IVSd、LVPWd、baPWV_L/R、IMT_L/R均显著高于对照组（t=2.307，t=2.516，t=3.250/2.790，t=2.372/3.425，P均<0.05）；观察组的颈动脉斑块所占比也显著高于对照组，χ2=27.833，P<0.001。结论 BPVSS能够全面的反映高血压患者靶器官损害的严重程度，BPV越大，该评分越低，其心脏和血管靶器官损害越严重。%Objective To investigate the relationship between a blood pressure variability (BPV)-based scoring system (BPVSS) and the target organ damage in patients with hypertension. Methods We selected 95 consecutive inpatients with essential hypertension admitted between January and June, 2015 in the Department of Cardiology of Guangzhou General Hospital of Guangzhou Military Command. The BPV indices were analyzed for their correlation with the parameters of target organ damage (IVSd, LVPWd, baPWV_L/R, and IMT_L/R). The patients with a BPVSS of 3.9 or higher (control, 43 cases) and those with a lower BPVSS (observation group, 52 cases) were compared for differences in IVSd, LVPWd, baPWV_L/R, IMT_L/R and the proportion of carotid plaques. Results Similar with the traditional BPV indices, BPVSS was negatively correlated with IMT_L/R (r=-0.278/-0.324, P<0.05). BPVSS was also negatively correlated with IVSd (r=-0.241), LVPWd (r=-0.223), and baPWV_L/R (r=-0.468/-0.373) (P<0.05). IVSd, LVPWd, baPWV_L/R and IMT_L/R were all significantly higher in the observation group than in the control group (t=2.307, 2.516, 3.250/2.790, and 2.372/3.425, respectively;P<0.05). The proportion of carotid plaques in the observation group was significantly higher than that in the control group (χ2=27.833, P<0.001). Conclusion BPVSS indicates the severity of target organ damage in patients with hypertension. A greater BPV is correlated with a lower BPVSS score and more severe damages of the heart and blood vessels.