高血压伴糖耐量减低患者血压晨峰与靶器官损伤的相关性  

Relationships between morning blood pressure surge and target organ damage among patients with hypertension and impaired glucose tolerance

作　　者：张存新[1] 陈俊华[1] ZHANG Cunxin;CHEN Junhua(Department of Cardiology,Xinjiang Autonomous Region Crops Hospital of Chinese People’s Armed Police Force,Urumqi 830091,China)

机构地区：[1]武警新疆总队医院心内科,乌鲁木齐830091

出　　处：《武警医学》2022年第4期327-330,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨高血压伴糖耐量减低患者血压晨峰(morning blood pressure surge,MBPS)与靶器官损伤的相关性。方法选取210例原发性高血压伴糖耐量减低患者,根据动态血压结果分为MBPS组(n=100)和非MBPS组(n=110),比较两组颈动脉内膜中层厚度(IMT)、颈动脉斑块(CA)、左心室肥厚、高血压眼底动脉病变、尿白蛋白/肌酐(MAU)等指标,评价晨峰血压与靶器官损伤的相关性。结果与非MBPS组比较,MBPS组24 h平均收缩压[(136.24±10.59)mmHg]、日间收缩压[(140.32±12.09)mmHg]和舒张压[(86.7±9.40)mmHg]、室间隔厚度[IVST,(12.2±1.4)mm]、左心室后壁厚度[LVPWT,(12.6±2.7)mm]、左心室舒张末期内径[LVEDD,(54.2±7.6)mm]、左室质量指数[LVMI,(147.2±29.8)g/m^(2)]、内膜-中层厚度[IM,(1.28±0.32)mm]均高于非MBPS组,差异有统计学意义。MBPS组颈动脉斑块检出率(47.0%)、左心室肥厚检出率(44.0%)、高血压眼底病变检出率(63.0%)均高于非MBPS组(33.0%、27.3%、46.4%),差异有统计学意义(P<0.05)。结论对于高血压伴糖耐量减低患者,MBPS可致IVST、LVPWT、LVEDD、LVMI增高,可能与颈动脉内膜中层增厚,高血压眼底病变等靶器官损伤相关。Objective To investigate the correlations between the morning blood pressure surge(MBPS)and target organ damage in patients with hypertension and impaired glucose tolerance.Methods Two hundred and ten primary hypertension patients with impaired glucose tolerance(IGT)were divided into the MBPS group(n=100)and non-MBPS group(n=110).The carotid intima-media thickness(IMT),carotid artery plaque(CA),left ventricular hypertrophy and hypertension fundus artery lesions,and urinary albumin/creatinine(MAU)were determined to assess the target organ damage by MBPS.Results The 24 h mean systolic blood pressure[(136.24±10.59)mmHg],daytime systolic blood pressure[(140.32±12.09)mmHg]and diastolic blood pressure[(86.7±9.40)mmHg],IVST[(12.2±1.4)mm],VPWT[(12.6±2.7)mm],LVEDD[(54.2±7.6)mm],LVMI[(147.2±29.8)g/m^(2)],and IM[(1.28±0.32)mm]were all higher in the MBPS group than in the non-MBPS group.The detection rates of carotid plaque(47.0%),left ventricular hypertrophy(44.0%)and hypertensive fundus lesions(63.0%)in the MBPS group were significantly higher than those of the non-MBPS group(33.0%,27.3%,46.4%).Conclusions For patients with hypertension with reduced glucose tolerance,MBPS can lead to the increase of IVST,LVPWT,LVEDD,LVMI,IMT,left ventricular hypertrophy and the incidence of hypertensive fundus lesions.Therefore,measures should be taken to control the MBPS in patients with hypertension complicated with IGT.

关 键 词：高血压 糖耐量减低 血压晨峰 靶器官损害 

分 类 号：R544.1[医药卫生—心血管疾病]