原发性高血压伴血脂异常患者的动态血压特点  

The characteristics of ambulatory blood pressure in patients with essential hypertension and dyslipidemia

作　　者：孟亚星 张小玲 严激 Meng Yaxing;Zhang Xiaoling;Yan Ji(Department of Cardiovascular,Anhui Provincial Hospital,Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学附属省立医院安徽省立医院心血管内科,合肥230001

出　　处：《中国临床保健杂志》2018年第3期323-327,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽省科技厅年度攻关项目(11070403049)

摘　　要：目的分析原发性高血压伴血脂异常的动态血压特点,并探讨血脂代谢异常与血压变异性之间的关系。方法入选150例原发性高血压(EH)患者,进行动态血压检查、测量低密度脂蛋白胆固醇(LDL-C)水平,根据LDL-C水平:LDL-C<3.4 mmol/L;LDL-C≥3.4 mmol/L,将EH组分为血脂正常组及高血脂组。收集并计算一系列相关的动态血压参数,进行比较。结果血脂异常组较血脂正常组24 h平均收缩压(24h MSBP)[(149.60±5.70)mm Hg比(139.93±4.18)mm Hg],白昼平均收缩压(d MSBP)[(152.60±5.70)mm Hg比(142.86±4.41)mm Hg],夜间平均收缩压(n MSBP)[(147.52±6.05)mm Hg比(134.88±5.70)mm Hg],24 h收缩压变异性(24h SBPV)[(12.33±0.89)mm Hg比(9.70±0.58)mm Hg],白昼收缩压变异性(d SBPV)[(10.72±2.24)mm Hg比(9.46±0.63)mm Hg]、夜间收缩压变异性(n SBPV)[(10.49±1.88)mm Hg比(9.13±0.69)mm Hg],晨峰收缩压[(35.53±2.98)mm Hg比(27.29±3.38)mm Hg]均增高,且差异有统计学意义(P<0.05)。血脂异常组多表现为"非杓型"血压(66.67%比28.00%)。血压变异性与LDL-C(r=0.342),三酰甘油(r=0.831)呈正相关,而与高密度脂蛋白胆固醇(r=-0.225)呈负相关。结论 LDL-C升高影响原发性高血压患者的血压数值及血压昼夜的节律;血脂代谢与原发性高血压患者的血压变异性有关。Objective To analyze the characteristics of ambulatory blood pressure in patients with essential hypertension and dyslipidemia,and investigate the relationship between abnormal lipid metabolism and blood pressure variability. Methods 150 patients with essential hypertension （EH） were selected and divided into the normal lipid group and the hyperlipidemia group according to the level of LDL-C：LDL-C〈3.4 mmol/L;LDL-C≥3.4 mmol/L,after measuring dynamic blood pressure and low density lipoprotein cholesterol （LDL-C） level.And we tested lipid indexes,collected and calculated a series of dynamic parameters of blood pressure for comparison. Results Compared with the normal lipid group,24hour mean systolic blood pressure（24hMSBP） [（149.60±5.70）mm Hg vs （139.93±4.18）mm Hg],day mean systolic blood pressure （dMSBP） [（152.60±5.7）mm Hg vs （142.86±4.41）mm Hg],night mean systolic blood pressure （nMSBP） [（147.52±6.05）mm Hg vs （134.88±5.70）mm Hg],24 hour systolic blood variability （24hSBPV） [（12.33±0.89）mm Hg vs （9.70±0.58）mm Hg],day systolic blood variability （dSBPV） [（ 10.72± 2.24）mm Hg vs （9.46±0.63）mm Hg],night systolic blood variability（nSBPV） [（10.49±1.88）mm Hg vs （9.13±0.69）mm Hg] and morning systolic blood pressure surge [（35.53±2.98）mm Hg vs （27.29± 3.38） mm Hg] in the dyslipidemia group were both higher,and the difference were statistically significant （ P 〈 0.05）.The dyslipidemia group mostly showed ＂non-dipper type＂ blood pressures （66.67% vs.28.00%）.Blood pressure variability was positively correlated with LDL-C （ r =0.342） and triacylglycerol （ r =0.831）,but negatively correlated with high-density lipoprotein cholesterol （ r =-0.225）.Conclusion The increase of LDL-C can affect blood pressure value and the rhythm of blood pressure day and night in patients with essential hypertension;lipid metabolism is related to blood pressure variability in patients with essential hypertension.

关 键 词：高血压 血脂异常 血压变异性 非杓型血压 

分 类 号：R544.11[医药卫生—心血管疾病] R589.21[医药卫生—内科学]