老年男性杓型高血压晨峰现象与踝肱指数和尿微量白蛋白/肌酐的关系  

Relationship between morning blood pressure surge and ankle brachial index,Um Alb / Cr in elderly male patients with dipper essential hypertension

作　　者：王华荣[1] 王淼[2] 李小彬[3] 汤玉平[4] 赵翠[2] 李伟[2] 王国玉[2] 闫妹姝[5] 

机构地区：[1]承德医学院附属医院急诊科 [2]承德医学院附属医院老年病科 [3]承德医学院学生处,河北承德067000 [4]承德市滦平县医院门诊部,河北滦平068250 [5]承德医学院附属医院检验科

出　　处：《临床和实验医学杂志》2014年第23期1938-1942,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省科技支撑计划项目(项目编号20123124)

摘　　要：目的研究老年男性杓型高血压晨峰(MBPS)现象与踝肱指数(ABI)、尿微量白蛋白/肌酐(Um Alb/Cr)的关系,探讨老年男性杓型高血压MBPS对动脉粥样硬化的影响。方法 251例老年男性杓型高血压患者,根据动态血压监测(ABPM)结果,分为MBPS组及NMBPS组,所有患者均进行ABI、Um Alb/Cr检测,并常规检测血尿素氮(BUN)、肌酐(Cr)、血糖(Glu)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TCH),分析比较两组患者ABI、Um Alb/Cr的差异。结果两组患者在性别构成比、年龄、吸烟、高血压病程、BUN、Cr、Glu、HDL-C、LDL-C、TG、TCH等方面比较,差异均无统计学意义(P>0.05)。MBPS组24 h SBP、d SBP、n SBP、24 h MAP、d MAP、MBPS变异幅度均显著高于NMBPS组(144.23±12.59比136.35±14.21、145.01±14.33比135.79±15.26、135.08±17.42比128.21±16.37、98.25±10.08比95.35±9.87、98.76±8.22比94.37±8.95、29.59±4.26比19.02±3.98),MBPS组ABI显著低于NMBPS组(0.73±0.09比1.02±0.09),MBPS组Um Alb/Cr显著高于NMBPS组(4.79±1.93比4.21±1.56),MBPS组PAD发生率、Um Alb/Cr阳性率显著高于NMBPS组(88/63比52/48、72/79比41/59),差异具有统计学意义(P<0.05)。SPEARMAN相关分析显示,MBPS与ABI、Um Alb/Cr呈中度相关,与年龄呈低度相关,差异具有统计学意义(P<0.05)。结论老年男性杓型高血压MBPS是导致PAD以及早期肾损害的重要的危险因素,对动脉粥样硬化产生重要影响。Objective To study the relationship between ankle brachial index（ ABI）,UmAlb / Cr and morning blood pressure surge （ MBPS）,and to investigate the impact of MBPS on atherosclerosis in elderly male patients with dipper essential hypertension. Methods Totally 251 elderly male patients with dipper essential hypertension were divided into MBPS group（observation group,n=151）and NMBPS group（control group,n=100）according to the results of ambulatory blood pressure monitoring（ABPM）. The ABI,UmAlb/Cr ratio,as well as blood urea nitrogen（BUN）,creatinine（Cr）,glucose（Glu）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,triglyceride（TG）and total cholesterol（TCH）were routine detected. The differences of ABI and UmAlb/Cr in the two groups were analyzed. Results There were no statistical significance in gender composition ratio,age,smoking,course of hypertension,BUN,Cr,Glu,HDL-C,LDL-C,TG and TCH between the two groups（ P ﹥0. 05）. Compared with NMBPS group,the 24 hSBP,dSBP,nSBP,24 hMAP,dMAP, and the amplitude of variation in morning systolic pressure peak were higher in MBPS group than those in NMBPS group（144. 23 ± 12. 59 vs. 136. 35 ± 14. 21,145. 01 ± 14. 33 vs. 135. 79 ± 15. 26,135. 08 ± 17. 42 vs. 128. 21 ± 16. 37,98. 25 ± 10. 08 vs. 95. 35 ± 9. 87,98. 76 ± 8. 22 vs. 94. 37 ± 8. 95,29. 59 ± 4. 26 vs. 19. 02 ± 3. 98）,the ABI was significantly lower than NMBPS group（0. 73 ± 0. 09 vs. 1. 02 ± 0. 09）,and the UmAlb/Cr was significantly higher than NMBPS group（4. 79 ± 1. 93 vs. 4. 21 ± 1. 56）,as well as the PAD incidence and UmAlb/Cr positive rate were much higher in MBPS group than those in NMBPS group（88/63 vs. 52/48,72/79 vs. 41/59）,the differences were statistically significant（ P ﹤0. 05）. Pearson correlation analysis showed that MBPS was moderately correlated with ABI,UmAlb/Cr,and it was lowly correlated with age,the differences were statistically significant（ P ﹤0. 05）. Conclusion The MBPS in

关 键 词：老年 男性 高血压 晨峰现象 踝肱指数 尿蛋白/肌酐 

分 类 号：R544.1[医药卫生—心血管疾病]