颈动脉窦部斑块与长时血压变异性的相关性  

The correlation study on carotid sinus plaque and visit-to-visit blood pressure variability

作　　者：姚涛[1] 赵性泉[2] 王张锋[1] 李丽[3] 陈朔华[4] 杨慧 刘向欣 朱颖 蒋雄京[8] 吴寿岭[9] 

机构地区：[1]开滦医疗集团林西医院心内科 [2]河北唐山063000 [2]首都医科大学附属天坛医院神经内科 [3]唐山工人医院分院心内科 [4]河北联合大学附属开滦医院重症医学科 [5]急诊科 [6]感染管理科 [7]感染科 [8]北京阜外心血管病医院心内科 [9]河北联合大学附属开滦医院心内科

出　　处：《中华高血压杂志》2013年第1期53-60,共8页Chinese Journal of Hypertension

基　　金：国家科技重大专项课题(2008ZX09312-008-004)

摘　　要：目的探讨颈动脉窦部斑块与长时血压变异性(BPV)的关系。方法在参加开滦集团年度健康体检的职工101510人中随机分层抽取5852例作为观察对象,于2010-2011年进行统一问卷调查、血液生化及颈动脉超声检查,最后符合入选标准的(年龄≥40岁、既往无脑卒中、短暂性脑缺血发作、心肌梗死者)为5440例,资料完整的4703例纳入统计分析,BPV采用2006-2007、2008-2009、2010-2011年度3次平均收缩压的标准差计算,并对BPV的相关危险因素进行多因素Logistic回归分析。结果在4703例观察对象中,男性为2863例,女性为1840例,年龄为(54.1±11.2)岁。颈总动脉无斑块者为2844例,单侧窦部斑块者为802例,双侧窦部斑块者为472例,窦部和主干均有斑块者为509例,单纯颈总动脉主干斑块者为76例。其中2351例观察对象的BPV≥9.65mmHg,占观察对象的50.0%;颈总动脉无斑块、单侧窦部斑块、双侧窦部斑块、窦部和主干斑块、单纯颈总动脉主干斑块人群BPV中位数分别为8.74、9.77、10.44、11.93、10.85mmHg,组间比较差异有统计学意义(P<0.05)。影响研究人群BPV的Logistic回归结果:校正其他因素后,双侧窦部、主干和窦部斑块仍为BPV升高的危险因素,其OR值分别为1.284(95%CI1.031～1.599)和1.779(95%CI1.406～2.252)。结论颈动脉窦部斑块与长时BPV的升高有关。Objective To investigate the correlation between carotid sinus plaque and visit-to-visit blood pressure variability （BPV）. Methods A stratified random sample of 5852 subjects was enrolled from 101 510 Kailuan Group staff underwent annual physical examination. The same questionnaires, blood biochemical tests and carotid artery ultrasonography were conducted during the period 2010-2011. Finally, 4703 well-documented individuals were included for statistical analysis after the 5440 eligible cases （aged over 40 years; with no history of stroke, transient ischemic attack, nor myocardial infarction） were recruited. Visit-to-visit BPV was calculated by standard deviation of mean systolic blood pressure measured in 2006-2007, 2008-2009 and 2010-2011. The related risk factors of BPV were analyzed by multivariate Logistic regression analysis. Results Among 4703 participants, 2863 indi- viduals were male and 1840 were females with an average age （54.1±11.2） years. There were 2844 cases without carotid plaques, 802 patients with unilateral sinus plaques, 472 eases with bilateral sinus plaques, 509 cases with si- nus and main trunk plaques and 76 cases with only main trunk plaques. The subjects charactered by BPV≥9.65 mm Hg were 2351 cases, occupying 50.0% of the cohort. The median BPV of without carotid artery plaques, uni- lateral sinus plaques, bilateral sinus plaques, sinus and main trunk plaques and only main trunk plaques was 8.74, 9.77, 10.44, 11.93 and 10.85 mm Hg, respectively （P〈0.05）. Bilateral sinus plaques （OR 1.284, 95% CI 1. 031-1. 599） as well as sinus and main trunk plaques （OR 1. 779, 95% CI 1. 406-2. 252） were still risk factors of increased BPV after adjustment for other risk factors by Logistic regression analysis. Conclusion Carotid sinus plaque is correlated with increased visit-to-visit BPV levels.

关 键 词：颈动脉窦部斑块 血压变异性 流行病学研究 

分 类 号：R544.1[医药卫生—心血管疾病]