正常高值血压人群动脉早期损害的评价  

Evaluation of early arterial damage in high-normal blood pressure population by augmentation index

作　　者：张英[1] 胡艳艳[1] 程云鹏[1] 姜一农[1] 

机构地区：[1]大连医科大学附属第一医院心内科,辽宁大连116011

出　　处：《大连医科大学学报》2017年第3期229-232,共4页Journal of Dalian Medical University

基　　金：辽宁省自然科学基金项目(2013B020)

摘　　要：目的探讨正常高值人群的动脉早期损害情况。方法连续选取2009年10月至2010年5月于大连医科大学附属第一医院体检中心体检的健康人群958人为研究对象,分为正常血压组(n=859)和正常高值血压组(n=99)。记录两组性别、年龄、身高、体质量、腰围、血压、心率、空腹血糖、血脂、血清肌酐、尿酸,计算体质量指数、肌酐清除率,测定桡动脉增强指数。并对两组各项指标进行比较。结果正常高值血压组的体质量、体质量指数、收缩压、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、尿酸及桡动脉增强指数高于正常血压组[(71.56±10.27)kg vs.(66.72±12.34)kg、(25.38±2.96)kg/m2vs.(23.74±3.33)kg/m2、(132.65±4.27)mm Hg vs.(114.53±8.73)mm Hg、(81.61±6.54)mm Hg vs.(70.61±7.32)mm Hg、(5.38±0.65)mmol/L vs.(5.21±0.60)mmol/L、(198.73±38.80)mg/d L vs.(186.20±34.51)mg/d L、(118.64±22.71)vs.(110.43±21.17)mg/d L、(296.32±89.41)μmol/L vs.(270.63±92.39)μmol/L、(79.39±12.91)%vs.(74.22±11.93)%;均P<0.05]。桡动脉增强指数与舒张压、总胆固醇呈正相关(r值分别为0.398、0.244;均P<0.05),与尿酸呈负相关(r=-0.293;P<0.05)。结论正常高值血压人群已存在早期动脉损害,且该组人群代谢异常较正常血压组更常见。Objective To appraise the vascular damage in high-normal blood pressure（HNBP） population by radial augmentation index adjusted to a heart rate of 75 beats/min（r AI75）. Methods Totally 958 subjects were recruited and classified into normal blood pressure group（NBP,n = 859） and HNBP group（n = 99）. Background data,including weight,height,body mass index（BMI）,waist circumstance（WC）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,fasting plasma glucose（FPG）,total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,creatinine（Cr）,and urea acid（UA） were collected. r AI75 was conducted in all subjects by tonometry according to the standard protocol. Results There were no significant differences in gender,age,height,HR,TG,HDL-C,clearance of Cr（CCr）between NBP group and HNBP group. But the weight,BMI,SBP,DBP,FPG,TC,LDL-C,UA,and r AI75 in HN-BP group were significantly higher than NBP group [（71. 56 ± 10. 27） vs.（66. 72 ± 12. 34） kg,（25. 38 ± 2. 96） vs.（23. 74 ± 3. 33） kg/m2,（132. 65 ± 4. 27） vs.（114. 53 ± 8. 73） mm Hg,（81. 61 ± 6. 54） vs.（70. 61 ± 7. 32） mmHg,（5. 38 ± 0. 65） vs.（5. 21 ± 0. 60） mmol/L,（198. 73 ± 38. 80） vs.（186. 20 ± 34. 51） mg/d L,（118. 64 ±22. 71） vs.（110. 43 ± 21. 17） mg/d L,（296. 32 ± 89. 41） vs.（270. 63 ± 92. 39） μmol/L,（79. 39 ± 12. 91） vs.（74. 22 ± 11. 93） %,all P〈0. 05]. r AI75 was positively correlated with DBP,TC and UA（r = 0. 398,0. 244,respectively,all P〈0. 05）,and negatively correlated with UA（r =-0. 293,P〈0. 05）. Conclusion The arterial stiffness and metabolic problem in HBNP group are significantly increased compared to NBP group. Medical interventions,at least lifestyle interventions are needed in this special population.

关 键 词：正常高值血压 反射波增强指数 动脉硬化 

分 类 号：R543.5[医药卫生—心血管疾病]