老年高血压病患者动态脉压与靶器官亚临床损害的关系  

Relationship between ambulatory pulse pressure and subclinical target organ damage in elderly patients with hypertension

作　　者：关浩增[1] 李醒三[2] 郭清[1] 陈敏[1] 莫永秀[1] 韦巍[1] 

机构地区：[1]广西壮族自治区江滨医院,南宁530021 [2]广西医科大学心血管病研究所心内科

出　　处：《广西医学》2005年第12期1909-1912,共4页Guangxi Medical Journal

摘　　要：目的探讨老年高血压病患者24h平均脉压(24hMPP)与靶器官亚临床损害之间的关系。方法对年龄在60岁以上的50例老年高血压病患者(高血压组)和30例非高血压病患者(对照组)进行观察,分别检查他们的24h动态血压(AMBP)、心脏和颈动脉超声及24h尿微量白蛋白含量,计算出相应的24h平均脉压、左心室重量指数(LVMI)、颈总动脉内膜-中膜厚度(CCA-I MT)和24h尿微量白蛋白排出率(UAE),并将两组的相应数据进行统计学分析。结果两组在年龄、性别、体表面积和血脂等方面差异无统计学意义(P>0·05)。高血压组的24hMPP、24hSBP和24hMDBP明显高于对照组(P<0·01),该组的LVMI,CCA-I MT和UAE与对照组相比较差异有极显著性(P<0·01)。高血压组的24hMPP与LVMI、CCA-I MT和UAE呈正相关(r分别为0·38,0·43,0·39,P<0·01)。结论24h动态脉压和LVMI、CCA-I MT、UAE之间存在着密切的关系,脉压与老年高血压病患者的靶器官亚临床损害有关,检测老年高血压病患者的24h平均脉压、左室重量指数、颈总动脉I MT和尿微量白蛋白排出率,将有利于对靶器官损害的早期发现和逆转。Objective To study the relationship between ambulatory pulse pressure and subclinical target organ damage in elderly patients with hypertenslon,Methods 50 patients with hypertension and 30 normotensive controls （age≥60 years） were measured of ambulatory blood pressure monitoring, echocardiograph, carotid ultrasonograph, microalbuminuria and parameters calculated including 24 hours ambulatory pulse pressure （24hMPP）, left ventricular mass index （LVMI）, common carotid intima-media thickness （CCA- IMT） and urinary albumin excretion（UAE）. And then, the parameters from the two groups were compared with each other.Results There were no significant difference between two groups in age, gender, body surface area （BSA） and plasma lipids. 24hMPP , 24hSBP, 24hMDBP , LVMI, CCA-IMT and UAE in hypertension group were significantly higher than those in control group （P〈 0.01）. 24hMPP in hypertension group was positively correlated with LVM], CCA-IMT and UAE （r=0.38, 0.43, 0.39, respectively. P 〈 0.01 ）. Conclusion There is significant correlation among ambulatory pulse pressure, LVMI, CCA-IMT and UAE. Pulse pressure is related to the subclinical target organ damage in elderly patients with hypertension. Monitoring 24hMPP, LVM], CCA-IMT and UAE in elderly hypertensive patients may be beneficial to early detection and reversion of target organ damage.

关 键 词：高血压 脉压 左室重量指数 颈动脉内膜-中膜厚度 老年人 微量白蛋白尿 

分 类 号：R544.1[医药卫生—心血管疾病]