亚临床甲状腺功能减退对更年期高血压妇女动态血压的影响  

Influence of subclinical hypothyroidism on ambulatory blood pressure in the patients with menopause hypertension

作　　者：张萍[1,2] 张虹[1] 刘杰[1] 

机构地区：[1]天津市南开医院心内科,300100 [2]天津中医药大学研究生部,天津300193

出　　处：《重庆医学》2014年第22期2865-2867,共3页Chongqing medicine

摘　　要：目的研究亚临床甲状腺功能减退(以下简称亚甲减)与更年期高血压妇女动态血压的关系。方法 45例合并亚甲减的更年期高血压妇女作为观察组(A组),58例单纯更年期高血压妇女作为对照组(B组)。常规测定两组患者收缩期及舒张期血压、身高、体质量、血尿素、肌酐、尿酸、空腹血糖、血脂、甲状腺功能及24h动态血压并分析相关指标。结果 A组舒张压、24h平均舒张压均高于B组[(89.76±11.54)mm Hg vs.(80.18±10.37)mm Hg,(81.05±10.45)mm Hg vs.(75.46±8.73)mm Hg,均P<0.01],A组夜间收缩压、舒张压下降率均低于B组[(6.43±3.56)%vs.(10.35±7.63)%,(8.49±6.35)%vs.(13.02±8.92)%,均P<0.01],A组非杓型血压的患者比例高于B组(62.22%vs.39.66%,P<0.05);多元线性回归分析结果显示,随年龄增大舒张压水平呈下降趋势,随血清促甲状腺激素(TSH)水平增高舒张压水平呈上升趋势,同时随BMI增高、血清TSH水平增高夜间血压下降率呈下降趋势。结论舒张压控制不良和昼夜节律紊乱的更年期高血压妇女应行甲状腺功能检查,有助于高血压病因的诊断。Objective To investigate the relationship between subclinical hypothyroidism and ambulatory blood pressure in the patients with menopause hypertension .Methods 45 menopause hypertensive patients complicated with subclinical hypothyroidism （group A）and 58 menopause hypertensive patients（group B）were studied .Systolic blood pressure ,diastolic blood pressure ,height , body mass ,urea nitrogen ,serum creatinine ,uric acid ,fasting plasma glucose ,blood lipid level ,thyroid function and 24 hours ambula-tory blood pressure were measured .Results The levels of diastolic blood pressure ,24 hours diastolic blood pressure were higher in group A than those in group B[（89 .76 ± 11 .54）mm Hg vs .（80 .18 ± 10 .37）mm Hg ,（81 .05 ± 10 .45）mm Hg vs .（75 .46 ± 8 .73） mm Hg ,P〈0 .01] .SBP and DBP nocturnal dipping were lower in group A than those in group B [（6 .43 ± 3 .56）% vs .（10 .35 ± 7 .63）% ,（8 .49 ± 6 .35）% vs .（13 .02 ± 8 .92）% ,P〈0 .01] .The proportion of non-dipper patients was higher in group A than that in group B（62 .22% vs .39 .66% ,P〈0 .05） .Multiple linear regression analysis showed that diastolic blood pressure decreased with the increasing of age ,and increased with the increasing of serum thyrotropin level .Nocturnal dipping decreased with the increasing of BMI and serum thyrotropin level .Conclusion Thyroid function tests should be performed in menopause hypertensive patients with poorly controlled diastolic blood pressure and non-dipping ,which contributes to the diagnosis of hypertension etiology .

关 键 词：高血压 亚临床甲状腺功能减退 24 h动态血压 血清促甲状腺激素 更年期 

分 类 号：R544.1[医药卫生—心血管疾病] R581.2[医药卫生—内科学]