夜间收缩压与亚临床心脑血管疾病超声指标的相关性研究  

Correlation between Nocturnal Systolic Blood Pressure and Ultrasound Index of Subclinical Cardiovascular and Cerebrovascular Diseases

作　　者：高洁[1] 于明月[1] 牛慧敏[1] GAO Jie;YU Mingyue;NIU Huimin(Hebei General Hospital,Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北省人民医院,石家庄050051

出　　处：《中西医结合心脑血管病杂志》2019年第1期83-86,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：河北省医学科学研究重点课题计划(No.1020140206)

摘　　要：目的探讨夜间收缩压与亚临床心功能和亚临床血管损伤之间的关系。方法通过斑点追踪超声心动图检测整体纵向应变(GLS)。在颈总动脉远端1 cm处测量颈动脉内中膜厚度(CIMT),记录颈动脉斑块是否存在。通过线性和Logistic回归分析夜间收缩压与GLS、CIMT和颈动脉斑块的关系。结果单纯夜间高血压组受试者CIMT和颈动脉斑块与对照组间差异存在统计学意义(P <0.05),单纯日间高血压组受试者各项指标与对照组比较差异均无统计学意义(P>0.05)。在单变量模型中,夜间收缩压与GLS(β=0.81,95%CI 0.33～1.47)和颈动脉斑块(OR=1.99,95%CI 1.14～3.28)显著相关,日间收缩压的单因素分析差异无统计学意义。在年龄和性别调整模型中,夜间收缩压和GLS(β=0.68,95%CI 0.11～1.25)仍显著相关,与颈动脉斑块的相关性无统计学意义。结论夜间收缩压与亚临床心血管疾病相关,且夜间收缩压比日间收缩压是一个更好的预后参数。Objective To examine the association of nocturnal systolic blood pressure(SBP)with subclinical cardiac dysfunction and subclinical vascular damage.Methods Global longitudinal strain(GLS)was measured by speckle -tracking analysis of echocardiogram images.Carotid intima-media thickness(CIMT)was measured at the distal 1 cm of the common carotid artery.The presence of carotid plaques was recorded.The association of nocturnal SBP with GLS,CIMT and carotid plaques was analyzed using linear and logistic regression.Results There were significant differences in CIMT and carotid plaques between the nocturnal hypertension group and the control group(P<0.05).There was no significant difference in the indexes between the daytime hypertension group and the control group(P >0.05).In the univariate model,nocturnal SBP was significantly associated with GLS(Beta=0.81,95%CI:0.33-1.47)and carotid plaque(OR=1.99,95%CI:1.14- 3.28).Univariable analysis of daytime SBP did not show any significant associations.In the age and gender adjustment models,nocturnal systolic pressure and GLS(Beta=0.68,95%CI:0.11-1.25)were still significantly correlated,and there was no statistically significant correlation with carotid plaque.Conclusion Nocturnal SBP is associated with subclinical cardiovascular disease.Nocturnal SBP is a better prognostic parameter compared with daytime SBP.

关 键 词：亚临床心脑血管疾病 夜间收缩压 整体纵向应变 颈动脉内中膜厚度 斑块 相关性 

分 类 号：R541[医药卫生—心血管疾病] R256.2[医药卫生—内科学]