血压正常高值人群的动脉弹性特点及影响因素分析  

Characteristics and related risk factors of arterial elasticity in prehypertensive persons

作　　者：喜杨[1] 孙宁玲[1] 祝之明 殷惠军[3] 陈源源[1] 王鸿懿[1] 

机构地区：[1]北京大学人民医院心脏中心,北京100044 [2]第三军医大学第三附属医院高血压及代谢病中心 [3]中国中医科学院西苑医院心血管科

出　　处：《中华医学杂志》2013年第4期265-269,共5页National Medical Journal of China

基　　金：国家"863"高技术研究发展计划

摘　　要：目的探讨正常高值血压、血脂和血糖人群的动脉弹性特点及其影响因素。方法从2008年3月至2009年12月从北京、重庆社区12899例自然人群中筛选出正常高值血压者65例、高值血脂者156例、高值血糖者159例、正常高值（血压＋血脂）者85例、正常高值（血压＋血糖）者77例、正常高值（血脂＋血糖）者55例、正常高值（血压＋血脂＋血糖）者9例。另将健康者332名、高血压患者113例、高脂血症患者150例及糖尿病患者37例作为对照。采用Dynapulse200M动脉弹性仪测定系统血管顺应性（SVC）、系统血管阻力（SVR）和肱动脉扩张性（BAD）。结果（1）高值血压者的SVC低于健康者[（1．14±0．20）ml比（1．26±0．23）ml，P〈0．01]，高于高血压患者[（1．11±0．18）ml，P=0．011]；SVR高于健康者[（157±29）kPa·S·L^-1。比（148±25）kPa·S·L^-1，P=0．012），低于高血压患者[（166±36）kPa·S·L^-1，P〈0．01]；BAD低于健康者（5．93％±1．14％比6．50％±1．30％，P〈0．01）。（2）不同正常高值亚组间的SVC、SVR、BAD差异均有统计学意义（均P〈0．05）。（3）多元线性回归分析显示，血压是血管功能的独立危险因素。结论血压正常高值阶段时，血管功能已经损害，血压是影响血管功能的独立危险因素。多种心血管危险因素在正常高值阶段的聚集对血管功能的影响更大。Objective To explore the characteristics and related risk factors of arterial elasticity in persons with prehypertension, high-normal blood lipid and（or） impaired glucose regulation（ impaired fasting glucose and （or） impaired glucose tolerance ）. Methods After receiving physical and biochemical examinations, a total of 1238 persons were enrolled. Among them, the etiologies were prehypertension （n = 65 ）, high-normal blood lipid （n = 156）, impaired glucose regulation （n = 159）, prehypertension and high- normal blood lipid （n = 85 ）, prehypertension and impaired glucose regulation （n = 77 ）, high-normal blood lipid and impaired glucose regulation （n = 55 ） and prehypertension, high-normal blood lipid and impaired glucose regulation （n = 9）. Also 332 healthy subjects, 113 hypertensive patients, 150 hyperlipidemics and 37 diabetics were enrolled as controls. Systemic vascular compliance （SVC）, systemic vascular resistance （SVR）, brachial artery distensibility （BAD） were measured with Dynapulse 200 M （Pulse Metric, Inc. , USA）. Results In persons with prehypertension, SVC was lower than healty group （ （ 1.14±0. 20） ml vs （ 1.26±0. 23） ml, P 〈0. 01 ） and higher than hypertensive group（ （ 1.11 ±0. 18） ml, P = 0. 011 ）, SVR higher than healty group （ 157 ±29）kPa·S·L^-1 - i vs （ 148 ± 25 ）kPa·S·L^-1 , p = 0. 012） and lower than hypertensive group（ （166±36）kPa·S·L^-1, P 〈 0. 01 ） and BAD lower than healty group （5.93%±1.14% vs 6. 50%±1.30%, P 〈 0.01 ）. Among different groups with prehypertension, high-normal blood lipid and（or） impaired glucose regulation, SVC, SVR and BAD had significant differences. As indicated by multiple linear regression analysis, blood pressure was an independent risk factor of arterial elasticity. Conclusions Vascular function becomes damaged in prehypertensive stage. As an independent risk factor,blood pressure had more potent effect than lipid and blood glucose. Multiple cardi

关 键 词：血压 高脂血症 血糖 动脉弹性 

分 类 号：R541.3[医药卫生—心血管疾病]