老年隐匿性高血压及白大衣性高血压对血管弹性及内皮功能的影响  

Effect of masked hypertension and white coat hypertension on vascular elasticity and endothelial function in elderly patients

作　　者：纪田田 魏芳[2] 王娟[3] 胡文静 段丹丹[1] 孙尚文[4] 张华[4] 柴强[4] 刘振东[4] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,250200 [2]济南市中心医院心血管内科 [3]山东大学第二医院心内科 [4]山东省医学科学院基础医学研究所

出　　处：《中华老年心脑血管病杂志》2018年第1期4-7,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81670432;81470489);山东省自然科学基金(ZR2016HM82;ZR2014HM098);山东省医药卫生科技发展计划项目(2015WS0187;2016WS0527);山东省中医药科技发展计划项目(2015-324);山东省重点研发计划项目(2017GSF218060)

摘　　要：目的探讨隐匿性高血压及白大衣性高血压对血管弹性及内皮功能的影响。方法选择健康体检老人487例,根据诊室血压和24h动态血压水平分为正常血压组128例,白大衣性高血压组115例,隐匿性高血压组112例和高血压组132例。检测所有受试者肱动脉血流介导的血管舒张功能(FMD)、NO、内皮素1及颈股动脉脉搏波传导速度(cfPWV)。结果与正常血压组比较,白大衣性高血压组、隐匿性高血压组及高血压组FMD、NO显著降低,内皮素1、cfPWV显著升高(P<0.05)。白大衣性高血压组和隐匿性高血压组FMD、NO较高血压组显著升高(P<0.05)。内皮素1、cfPWV较高血压组显著降低[(45.63±6.76)ng/L、(45.20±7.00)ng/L vs(49.04±6.93)ng/L,(10.91±1.08)cm/s、(10.87±0.96)cm/s vs(11.75±1.35)cm/s,P<0.05]。回归分析显示,以正常血压为参照,校正混杂因素后,白大衣性高血压、隐匿性高血压及高血压是FMD、NO、内皮素1及cfPWV的独立影响因素(P<0.01)。结论白大衣性高血压及隐匿性高血压是血管弹性下降及内皮紊乱的危险因素。Objective To study the effect of masked hypertension（MH）and white coat hypertension（WCH）on vascular elasticity and endothelial function in elderly patients.Methods Four hundred and eighty-seven elderly patients who underwent physical examination in our our hospital were divided into normotension group（n=128）,WCH group（n=115）,MH group（n=112）and hypertension group（n=132）according to their diagnostic office blood pressure and 24 hambulatory blood pressure.The brachial artery FMD,serum NO and endothelin-1（ET-1）levels,and cfPWV were measured.Results The FMD and serum NO level were significantly lower while the serum ET-1 level and cfPWV were significantly higher in WCH group,MH group and hypertension group than in normotension group（P〈0.05）.The FMD and serum NO level were significantly higher while the serum ET-1 and cfPWV were significantly lower in WCH group and MH group than in hypertension group（P〈0.05）.Multivariate linear stepwise regression analysis showed that WCH,MH and hypertension were the independent influencing factors for FMD,serum NO and ET-1 level and cfPWV with normotension used as reference after adjustment of confounding factors（P〈0.01）.Conclusion MH and WCH are the risk factors for the decreased vascular elasticity and endothelial dysfunction in elderly patients.

关 键 词：高血压 血压监测 便携式 内皮 血管 

分 类 号：R544.1[医药卫生—心血管疾病]