非高血压中老年人群血压变化与颈动脉斑块的相关性  

The relationship between change in blood pressure and carotid artery plaque in middle-aged and elderly population without hypertension

作　　者：李雯[1] 赵剑秋 李俊娟[3] 刘雪梅[4] 李晓庆[4] 黄玮[4] 邵丹[4] 张丽[4] 吴寿岭[5] 

机构地区：[1]上海市第六人民医院超声科,上海200000 [2]上海市嘉定区安亭医院麻醉科 [3]开滦总医院肾内科 [4]开滦总医院超声科 [5]开滦总医院心内科

出　　处：《中华高血压杂志》2017年第2期152-156,共5页Chinese Journal of Hypertension

摘　　要：目的探讨开滦研究队列基线(2006年)血压水平及4年后(2010年)血压变化与颈动脉斑块检出率的关系。方法在参加2006-2007年度开滦集团健康体检的职工101 510人中分层随机抽取观察对象,按入选标准选取观察对象5440人组成研究队列,于2010-2011年对观察队列进行健康体检,并进行颈动脉超声检查。选取队列中非高血压人群共计3802人进行统计分析。根据基线血压和4年间血压变化进一步分为:(1)稳定为正常血压组(n=673);(2)正常血压进展为正常高值血压组(n=793);(3)正常血压进展为高血压组(n=408);(4)正常高值血压降为正常血压组(n=295);(5)稳定为正常高值血压组(n=915);(6)正常高值血压进展为高血压组(n=718),观察血压变化与颈动脉斑块的关系。结果正常血压人群颈动脉斑块的检出率为32.4%,正常高值血压人群颈动脉斑块的检出率为38.1%;正常血压稳定为正常血压、进展为正常高值血压组及进展为高血压组斑块的检出率分别为19.2%、32.5%、54.2%;正常高值血压降为正常血压组、稳定为正常高值血压组及进展为高血压组斑块的检出率分别为27.8%、34.4%、46.9%。调整其他危险因素后,与稳定为正常血压组比较,正常血压进展为高血压组、正常高值血压降为正常血压组、稳定为正常高值血压组和正常高值血压进展为高血压组发生颈动脉斑块的OR值(95%CI)分别为2.451(1.604~3.744)、1.513(1.019~2.247)、1.643(1.212~2.228)和2.268(1.643~3.123)。结论非高血压人群中,随着血压水平的升高,颈动脉斑块的检出率增加。血压稳定在正常水平动脉粥样硬化风险较低。Objective To explore the relationship between change in blood pressure and detection rate of carotid artery plaque during the four years from 2006 to 2010in Kailuan study cohort. Methods According to the inclusion criteria,a total of 5440 participants were selected from 101 510 staff of Kailuan Group Company with the randomly stratified sampling method,who underwent health examinations between the year 2006 and 2007. And then these participants underwent follow-up health examinations and carotid artery ultrasonography between the year 2010 and 2011. 3802 participants without hypertension were included for the final analysis. According to the change in blood pressure during the four years,3802 participants were divided into 6 groups：（1）stable at normal blood pressure group（n=673）;（2）normal blood pressure progressing to high-normal blood pressure group（n=793）;（3）normal blood pressure progressing to hypertension group（n=408）;（4） high-normal blood pressure dropping to normal blood pressure group（n=295）;（5）stable at high-normal blood pressure group（n=915）;（6）high-normal blood pressure progressing to hypertension group（n=718）. The relationship between the change in blood pressure and carotid artery plaque was analyzed. Results The detection rates of carotid artery plaque in the participants of normal blood pressure and of high-normal blood pressure were 32.4%and 38.1%,respectively. The detection rates of carotid artery plaque in the stable at normal blood pressure group,normal blood pressure progressing to high-normal blood pressure group and normal blood pressure progressing to hypertension group were 19.2%,32.5% and 54.2%,respectively. The detection rates of carotid artery plaque in the high-normal blood pressure dropping to normal blood pressure group,stable at high-normal blood pressure group and high-normal blood pressure progressing to hypertension group were 27.8%,34.4% and 46.9%,respectively. After adjusting for other risk factors,compared to the stable at norma

关 键 词：颈动脉斑块 中老年 血压变化 正常高值血压 正常血压 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]