不同形态血压晨峰对老年人脑梗死、左心室肥厚以及颈动脉内膜增厚的影响  

The influence of different types of morning blood pressure surge on the cerebral infarction,left ventricular hypertrophy and carotid intima-media thickness in elderly patients with essential hypertension

作　　者：王吉 王浩[2] 秦爱梅[2] 朱兵[2] 杜凯音 苑学愚 付思齐 王津 孙洪良 胡智 骆雷鸣[2] 

机构地区：[1]解放军海军总医院干部保健科,北京100048 [2]解放军总医院南楼临床部心血管二科

出　　处：《中国临床保健杂志》2014年第6期561-563,共3页Chinese Journal of Clinical Healthcare

基　　金：中央保健专项资金科研课题(B2009B108)

摘　　要：目的探讨老年原发性高血压患者不同形态血压晨峰(MBPS)对脑梗死(CI)、左心室肥厚(LVH)以及对颈动脉内膜增厚(IMT)的影响。方法对320例老年原发性高血压患者进行24 h动态血压监测(ABPM)、头颅CT、头颅MR、头颅DSA和超声心动图检查以及颈动脉超声,将MBPS值≥35 mm Hg的119例患者入选为MBPS研究对象,根据其血压形态,分为勺型晨峰组76例(超勺型7例及勺型69例)、非勺型晨峰组43例(反勺型3例及非勺型40例),分别对各组患者的血脂、血糖等生化指标,以及脑梗死、左室肥厚、双侧颈动脉内膜等进行分析。结果 (1)勺型晨峰组与非勺型晨峰组之间的临床指标组间差异无统计学意义(P>0.05);(2)非勺型晨峰组脑梗死发病率、左心室肥厚检出率、颈动脉内膜增厚检出率高于勺型晨峰组(P<0.05)。结论老年性高血压非勺型血压晨峰患者脑梗死发生率明显高于勺型血压晨峰患者,更易引起左室肥厚和颈动脉硬化。Objective To investigate the influence of different types of morning blood pressure surge（MBPS） on the cerebral infarction h（CI）,left ventricular hypertrophy （LVH）and carotid intima-media thickness（IMT）in elder-ly patients with essential hypertension.Methods A total of 320 elderly hypertension patients underwent 24-hour ambula-tory blood pressure monitoring （ABPM）,brain CT or MRI or cerebral digital subtraction angiography （DSA）and echocar-diography and carotid arteries ultrasound examination.According to the value of MBPS（MBPS≥35 mm Hg）,119 patients were selected as the MBPS group,and the blood pressure types were dertermined.The patients were divided into 2 groups：dipper MBPS group （76 patients：7 patients with extreme-dipper and 69 patients with dipper）and non-dipper MBPS group （43 patients：3 patients with reverse-dipper and 40 patients with non-dipper）.The level of blood lipid,blood sugar and oth-er biochemical indicators,as well as single and double side carotid intima-media thickness,left ventricular hypertrophy were tested and analyzed.Results （1 ）There were no significant differences in clinical manifestations between non-dip-per MBPS group and non-dipper MBPS group（P 〉0.05）.（2）In non-dipper MBPS group,the level of cerebral infarction, LVH and IMT were higher than those in dipper MBPS（P 〈0.05）.Conclusion Non-dipper MBPS is related to the CI, LVH and IMT in the elderly hypertensive patients.

关 键 词：血压 昼夜节律 脑梗死 肥大 左心室 动脉粥样硬化 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]