高龄高血压患者血压变异性与认知功能损害  

Blood pressure variability and cognitive impairment in very elderly hypertensive patients

作　　者：薛嫱[1] 宋丽清[1] 田巍[1] 邓晓慧[1] 张萍[1] XUE Qiang;SONG Li-Qing;TIAN Wei;DENG Xiao-Hui;ZHANG Ping(Department of Cadres Healthcare,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院干部保健科,北京100035

出　　处：《中华老年多器官疾病杂志》2018年第6期407-411,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市保健科研课题(11-06)~~

摘　　要：目的探讨高龄高血压患者血压变异性与认知功能损害的关系。方法入选2017年3月至2017年12月北京积水潭医院干部保健科高龄高血压住院患者177例,根据认知功能评估结果分为轻度认知障碍(MCI)组114例和认知正常组63例,比较2组患者的一般情况、实验室检查、平均血压、血压变异系数、昼夜节律和晨峰血压。采用SPSS 17.0统计软件对数据进行处理。组间比较采用t检验或χ~2检验。结果 2组患者一般情况差异无统计学意义(P>0.05)。与MCI组患者相比,认知正常组患者收缩压变异系数[(0.11±0.02)%vs(0.08±0.03)%]、舒张压变异系数[(0.12±0.02)%vs(0.11±0.03)%]水平明显增高,差异具有统计学意义(P<0.05)。2组患者收缩压下降率、舒张压下降率和舒张压晨峰差异无统计学意义(P>0.05)。MCI组患者收缩压晨峰明显高于认知正常组患者[(17.37±5.36)vs(13.60±3.57)mm Hg],差异有统计学意义(P<0.05)。2组患者非杓型、杓型、反杓型和超杓型血压比例差异无统计学意义(P>0.05)。结论控制血压变异性及收缩压晨峰有利于改善高龄高血压患者的认知功能。Objective To explore the relationship of blood pressure variability and cognitive impairment in the very elderly patients with hypertension. Methods A total of 177 hypertensive patients（ 80-91 years old） admitted in our department from March to December 2017 were recruited in this study. According to the results of Montreal cognitive assessment（ Mo CA）,the patients were divided into mild cognitive impairment group（ MCI group,n = 114） and normal cognitive group（ control group,n = 63）. The general conditions,laboratory examination results,mean blood pressure,variable coefficient and circadian rhythms of blood pressure,and morning surge in blood pressure were compared between the 2 groups. SPSS statistics 17. 0 was used to perform the statistical analysis.Student＇s test or Chi-square was employed for comparison between two groups. Results There were no significant differences in general conditions between the 2 groups（ P 0. 05）. The patients from MCI group had obviously higher variable coefficient of systolic blood pressure [（ 0. 11 ± 0. 02） % vs（ 0. 08 ± 0. 03） %,P 0. 05] and diastolic blood pressure [（ 0. 12 ± 0. 02） % vs（ 0. 11 ± 0. 03） %,P 0. 05] than those in the control group. No significant differences were seen in declined rate of systolic blood pressure and diastolic blood pressure and morning diastolic blood pressure surge between the 2 groups（ P 0. 05）. The morning systolic blood pressure surge was also significantly higher in the MCI group than the control group [（ 17. 37 ± 5. 36） vs（ 13. 60 ± 3. 57） mm Hg,P 0. 05]. No significant differences were seen in the ratios of patients presenting non-dipper type,dipper type,reverse dipper type and over dipper type of blood pressure between the 2 groups（ P 0. 05）. Conclusion Controlling blood pressure variability and morning systolic blood pressure surge is helpful to the improvement of cognitive function in very elderly hypertensive patients.

关 键 词：认知障碍 昼夜节律 血压 老年人 

分 类 号：R592[医药卫生—老年医学]