24 h动态收缩压与老年人颈动脉内膜中层厚度的相关性分析  

Correlation study of the 24-hour ambulatory systolic blood pressure and carotid intima-media thickness in the elderly

作　　者：黄科宇[1] 李春慧 赵华灵 宋路 王一鸣 杨慧[2] 孟令民[2] 朱颖[2] 

机构地区：[1]开滦总医院医教部,河北省唐山市063000 [2]开滦总医院心内科,河北省唐山市063000 [3]华北理工大学研究生学院

出　　处：《中国综合临床》2016年第7期585-589,共5页Clinical Medicine of China

基　　金：河北省医学科学研究重点课题（20150845）I临床实验注册号：ChiCTR-TNC-11001489

摘　　要：目的：探讨24 h动态SBP与老年人群颈动脉内膜中层厚度（ CIMT）的关系。方法随机抽取符合入选标准的年龄≥60岁的开滦集团离退休员工2464名进行动态血压监测、颈部血管彩超等检查。采用多因素线性回归分别分析24 h、日间、夜间SBP与CIMT的关系。结果（1）分别按照24 h、日间、夜间收缩压三分位数将研究对象分为3组， CIMT随着24 h、日间、夜间SBP升高而呈增加趋势（ P均＜0．001）。（2）校正混杂因素后的多因素线性回归分析显示：24 h、日间、夜间SBP 与CIMT呈线性相关（P均＜0．05），回归系数（95％CI）分别为0．022（0．009～0．035），0．021（0．008～0．035），0．019（0．006～0．032）。此外，诊室SBP也分别进入上述回归方程，回归系数（95％CI）分别为0．016（0．003～0．029），0．016（0．003～0．030），0．019（0．007～0．032）。结论24 h动态SBP升高对CIMT的影响大于诊室SBP，积极监测24 h动态血压并保持血压较低的稳定水平对预防和延缓动脉粥样硬化是非常必要的。Objective To investigate the correlation of the 24？hour ambulatory systolic blood pressure （SBP） and carotid intima？media thickness（CIMT） in the elderly. Methods A total of 2 464 who were more than or equal to 60 years old participants were selected with random sampling in accordance with the inclusion criteria from the retired workers in Tangshan Kailuan Company. Dynamic blood pressure monitoring, neck vascular ultrasound and other examination were performed for the participants. . Multivariable linear regression analysis was used to analyze correlation between the SBP of 24？hour, daytime and nightime with CIMT, respectively. Results （ 1） The observation population was divided into three groups according to the tertiles of SBP of 24？hour, daytime and nightime, respectively. With the levels of different SBPs inceasing, CIMT values thickened markedly （ P〈0. 01 ） . （ 2 ） Multivariable linear regression analysis showed that after adjusting for confounding factors,the SBP of 24？hour,daytime and nightime associated with CIMT positively and linearly（P〈0. 05）,and regression coefficient（95%CI） were 0. 022（0. 009-0. 035）, 0. 021（0. 008-0. 035）, 0. 019 （ 0. 006-0. 032） respectively. In addition,clinic SBP step into the multivariable linear regression,and regression coefficient （ 95%CI ） were 0. 016 （ 0. 003-0. 029 ） , 0. 016 （ 0. 003-0. 030 ） , 0. 019 （ 0. 007-0. 032 ） , respectively. Conclusion The effect of increased 24？hour ambulatory SBP on CIMT was greater than the clinic SBP. Active monitoring of 24 h ambulatory blood pressure and maintaining a low level of blood pressure is essential for preventing and delaying atherosclerosis.

关 键 词：动态收缩压 颈动脉内膜中层厚度 老年人 

分 类 号：R587.2[医药卫生—内分泌]