老年人杓型与非杓型高血压对外周血管和肾脏的损害  

Study of periphery artery and renal injury in elderly patients with dipper and non-dipper isolated systolic

作　　者：袁公贤[1] 王桦[1] 任江华[2] 黄从新[4] 汪迎晖[3] 刘珍丽[1] 

机构地区：[1]武汉大学中南医院综合科,武汉430071 [2]武汉大学中南医院心内科,武汉430071 [3]武汉大学中南医院超声影像科,武汉430071 [4]武汉大学人民医院心内科

出　　处：《中华老年医学杂志》2012年第5期380-383,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年人单纯收缩期高血压（ISH）杓型与非杓型变化对外周动脉和。肾脏损害的影响。方法按照动态血压仪检测结果，共纳入187例老年人，其中ISH非杓型组51例、杓型组70例，平均年龄（72．4±5．6）岁，正常血压对照组66例，平均年龄（71．7±5．3）岁；测定各组踝臂指数（ABI）、肱踝动脉脉搏波传导速度（baPWV）、血视黄醇结合蛋白（RBP）、血胱氨酸蛋白酶抑制剂C（CystatinC）值。结果非杓型组baPWV为（1869．3±285．6）cm／s，高于杓型组（1703．1±235．2）cm／s（q=4．73，P〈O．01），非杓型组ABI为1．0±0．2，低于杓型组1．1土0．2（q=4．74，P％0．01）；非杓型组血CystatinC为（1．4±0．5）mg／L，高于杓型组患者的（1．0±0．5）mg／L（q=6．92，P〈O．01），杓型与非杓型ISH组血RBP值均高于对照组，但3组间差异无统计学意义（F=2．39，P〉0．05）。当baPWV〉1400cm／s时，非杓型组和杓型组例数分别为47例和64例，非杓型CystatinC水平为（1．4±0．5）mg／L，高于杓型组（1．1±0．5）mg／L（q=5．59，P〈0．01）。结论老年人ISH非杓型血压昼夜节律异常较杓型更易发生外周动脉、肾脏损害。[Abstract] Objective To evaluate periphery artery and renal injury in elderly patients with dipper and non-dipper isolated systolic hypertension（ISH）. Methods Totally 187 elderly cases were divided into 51 patients with non-dipper hypertension, 70 patients with dipper hypertension aged （72.4±5.6） years and 66 cases with normal blood pressure as control according to results of dynamic blood pressure recorder. Ankle-brachial index （ABI）, brachial ankle artery pulse wave velocity （baPWV）, retinol-binding protein （RBP） and Cystatin C were assessed. ABI and baPWV were determined by a non-invasive automatic waveform analyzer. Results The baPWV value in non dipper group was higher than dipper group （1869.3±285.6）em/s vs. （1703.1 ±235.2）cm/s, q= 4.73, P〉0.01], while the value of ABI in non-dipper group was lower than dipper group （1.0±0.2 vs. 1.1±0.2, q=4.74, P〉0.01）. The level of Cystatin C was elevated in non-dipper group versus dipper group [（1.44-0.5） mg/L vs. （1.04-0.5）mg/L, q^6.92, P（0 .01]. There were no differences in RBP concentration among the three groups （F= 2.39, P〉0.05）. At baPWV〉 1400 cm/s, the level of Cystatin C was increased in 47 cases with non-dipper hypertension as compared with 64 cases with dipper hypertension [（1.44-0.5）mg/L vs. （1.14-0.5）mg/L, q=5.59, P%0 . 013. Conclusions The elderly patients with non-dipper hypertension may be more easily suffered from periphery artery and renal injury in comparison with dipper hypertension.

关 键 词：高血压 动脉粥样硬化 昼夜节律 肾功能不全 慢性 

分 类 号：R544.1[医药卫生—心血管疾病]