老年原发性高血压患者血压变异性与血栓前状态关系的研究  

Correlation between blood pressure variability and prethrombotic state in elderly primary hypertensive patients

作　　者：杨中良[1] 张彩萍 王乃玲[3] 李剑[3] 茅娟 刘卫东 

机构地区：[1]上海市浦东新区浦南医院ICU,200125 [2]浙江省临海市第一人民医院心电图室 [3]上海市浦东新区浦南医院心内科,200125 [4]上海市蓝十字医学科学研究所

出　　处：《中华老年心脑血管病杂志》2012年第7期691-693,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年原发性高血压患者血压变异性与血栓前状态的关系及其临床意义。方法随机选择年龄≥60岁的老年高血压患者110例(高血压组)和老年健康体检者105例(对照组),以动态血压监测仪监测2组24 h血压变化,检测血浆血管性假血友病因子、纤维蛋白原和D-二聚体等血栓前状态指标的水平,并进行分析。结果高血压组昼间、夜间和24 h收缩压变异程度显著高于对照组(P<0.01),血浆血管性假血友病因子、纤维蛋白原和D-二聚体水平均明显高于对照组(P<0.01)。高血压组和对照组24 h收缩压变异程度与血管性假血友病因子均呈显著正相关(r=0.685,0.603,P<0.05)。结论老年原发性高血压患者血压变异性增高,并伴有明显的血管性假血友病因子、纤维蛋白原和D-二聚体水平升高,提示其存在内皮功能损害的可能,血压波动增大可能是内皮功能损害的危险因素。Objective To study the correlation between blood pressure variabili thrombotic state in elderly primary hypertensive patients and its clinical sign ty （BPV） and pre ificance. Methods One hundred and ten hypertensive patients aged over 60 years served as a hypertension group and 105 healthy elderly subjects served as a control group. Their 24 h ambulatory blood pressures were monitored and yon Willebrand factor（vWF）, fibrinogen（Fib） and D-dimer（DD）levels were measured. Results The day,night and 24 h SBP variability（24 h SBPV） and plasma vWF,Fib and DD levels were significantly higher in hypertension group than in control group（P^0.01）. The 24 h SBPV was positively correlated with vWF levels in two groups（r= 0. 685 and 0. 603, P% 0.05）. Conclusion The BPV and plasma vWF,Fib and DD levels are elevated in elderly primary hypertensive patients, suggesting that their endothelial function is probably impaired. Increased bloool pressure fluctuation may be a risk factor for the endothelial function impairment.

关 键 词：高血压 血压测定 血压监测 便携式 血栓形成 纤维蛋白原 昼夜节律 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]