1461名老年患者血压波动与颈动脉斑块形成关系的研究  

Clinical Investigation on Fluctuations of Blood Pressure Related to the Formation of the Carotid Atherosclerotic Plaque in 1461 Older Patients

作　　者：方根强[1] 李皓雲[1] 黄震浩[1] 荣棣君[1] 郝长宁[1] 石一沁[1] 段俊丽[1] 

机构地区：[1]上海交通大学医学院附属新华医院老年医学科,上海200092

出　　处：《现代生物医学进展》2013年第27期5275-5278,共4页Progress in Modern Biomedicine

基　　金：国家重点基础研究发展项目(973)(2009CB521900)

摘　　要：目的:除了血压水平的高低以外,血压波动也是造成人体靶器官损伤的独立危险因素。本研究以老年男性人群为研究对象,观察血压波动(BPV)与颈动脉斑块形成的关联性。方法:本研究选用1461名患有动脉硬化的老年男性患者为研究对象,将入选对象分为:非颈动脉斑块组和颈动脉斑块组,根据24小时动态血压测定(ABPM)中收缩压(SBP)、舒张压(DBP)的数据,用"个体血压波动法"测定每个患者的血压波动,分析探讨血压波动与颈动脉斑块形成之间的关联性。结果:①颈动脉斑块的形成与24小时收缩期血压波动(SBPV)密切相关(8.3±2.1 mmHg vs 7.9±2.0 mmHg;P<0.001),其中与白昼(6:00-22:00)SBPV有关(8.1±2.1mmHg vs 7.7±2.1 mmHg;P<0.001),而与夜间(22:00-6:00)SBPV关系不明显(8.9±3.8 mmHg vs 8.6±3.7 mmHg;P>0.05)。②与24小时舒张期血压波动(DBPV)有关(5.6±1.4 mmHg vs 5.4±1.4 mmHg;P<0.05),其中与白昼(6:00-22:00)舒张期血压波动有关(5.4±1.4 mmHg vs 5.2±1.4 mmHg;P<0.05),而与夜间舒张期血压波动无关(6.2±2.7 mmHg vs 5.9±2.5 mmHg;P>0.05)。结论:在老年男性人群中,颈动脉斑块的形成与收缩期和舒张期血压波动均有关系,主要表现在白昼血压波动。Objective： Blood pressure variability was also an independent determinant of the target-organ damage as well as the high blood pressure itself. The aim of this study was to investigate the relationship between carotid atherosclerotic plaque and fluctuations of blood pressure in elderly people. Methods： 1461 cases were enrolled in the study. All patients underwent ambulatory blood pressure monitoring and extracranial carotid ultrasound examination. Extracranial carotid artery plaque index （PI） was calculated, and patients were grouped as carotid plaque group and normal group （control group） according to the results of PI. The data of systolic blood pressure and diastolic blood pressure from ambulatory blood pressure were collected and compared between the two groups. Results： （1）Fluctua- tions of systolic blood pressure were closely related with the formation of the carotid atherosclerotic plaque in the plaque g（oup （8.3 ± 2.1 mmHg vs 7.9 ± 2.0 mmHg, P〈0.001）, especially in day time （6：00-22：00） （8.1 ± 2.1 mmHg vs 7.7 ± 2.1 mmHg, P〈0.001）,but no difference were found in night time （22：00-6：00） （8.9 ± 3.8 mmHg vs 8.6 ± 3.7 mmHg, P〉0.05）. （2）And the formation of carotid atherosclerotic plaque was also related more significantly to the diastolic blood pressure variability in carotid plaque group （5.6 ± 1.4 mmHg vs 5.4 ± 1.4 mmHg, P〈0.05）, especially in day time （6：00-22：00） （5.4 ± 1.4 mmHg vs 5.2 ± 1.4 mmHg, P 〈 0.05）, but no dif- ference was found in night time between the two groups （22：00-6：00） （6.2 ± 2.7 mmHg vs5.9 ：1： 2.5 mmHg, P〉0.05）. Conclusion： The formation of the carotid atherosclerotic plaques in older people is related significantly with the fluctuation of both systolic and diastolic blood pressure, mainly with the day time fluctuation.

关 键 词：血压水平 血压波动 颈动脉斑块 

分 类 号：R54[医药卫生—心血管疾病]