中老年人群血压变化与新发颈动脉斑块的关系探讨  

Study on the relationship between blood pressure changes and new carotid artery plaque in middle-aged and elderly people

作　　者：李雯 赵剑秋 李俊娟[3] 宋璐 陈朔华[4] 吴寿岭[4] LI Wen;ZHAO Jian-qiu;LI Jun-juan;SONG Lu;CHEN Shuo-hua;WU Shou-ling(Department of Ultrasound,East Hospital of the Sixth People's Hospital Affiliated to Shanghai Health Medical College,Shanghai 200120;Department of Anesthesiology,Anting Hospital of Jiading District,Shanghai 201800;Department of Nephrology,Tangshan Kailuan General Hospital,Tangshan Hebei 063004,China;Department of Cardiology,Tangshan Kailuan General Hospital,Tangshan Hebei 063004,China)

机构地区：[1]上海健康医学院附属第六人民医院东院超声科,上海200120 [2]上海市嘉定区安亭医院麻醉科,201800 [3]唐山开滦总医院肾内科,河北唐山063004 [4]唐山开滦总医院心内科,河北唐山063004

出　　处：《蚌埠医学院学报》2019年第11期1522-1525,1529,共5页Journal of Bengbu Medical College

基　　金：上海健康医学院种子基金项目(HMSF-17-22-028)

摘　　要：目的:探讨开滦研究队列基线(2010年)血压水平及2年后(2012年)血压变化对新发颈动脉斑块的影响。方法:选择来自开滦研究中的脑卒中队列作为研究对象,2010年和2012年分别对观察队列进行健康体检,并进行颈动脉超声检查。选取队列中基线非高血压且无斑块人群1 445例进行分析。根据基线血压及2年间血压变化进一步分为:稳定为正常血压组(Ⅰ组)284例,正常血压进展为正常高值血压组(Ⅱ组)184例、正常高值血压降为正常血压组(Ⅲ组)238例,稳定为正常高值血压组(Ⅳ组)498例,正常血压或正常高值血压进展为高血压组(Ⅴ组)241例。观察血压变化与2012年新发颈动脉斑块的关系。结果:2年后正常高值血压人群颈动脉新发斑块检出率高于正常血压人群(P<0.01)。Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ组新发斑块的检出率分别为18.9%、14.3%、17.1%、24.2%、26.4%,随着血压水平的增加,新发斑块的检出率呈增加趋势(P<0.05)。调整混杂因素后,与Ⅱ组比较,Ⅳ组、Ⅴ组发生颈动脉斑块的RR值(95%CI)分别为2.007(1.162~3.464)和1.823 (1.009~3.291)。结论:非高血压人群中,颈动脉斑块的检出率随着血压水平的升高而增加。与正常血压进展为正常高值血压比较,血压稳定在正常高值水平颈动脉粥样硬化风险已经增加。Objective:To investigate the effects of baseline blood pressure level of the Kailuan cohort study(2010) and blood pressure changes 2 years later(2012) on newly developed carotid artery plaque.Methods:The physical examination and carotid ultrasound in stroke cohort in Kailuan study were performed in 2010 and 2012,respectively.According to the changes of blood pressure during the two years,the 1 445 participants were divided into the normal blood pressure group(group Ⅰ,n=284),normal blood pressure progressing to high-normal blood pressure group(group Ⅱ,n=184),high-normal blood pressure dropping to normal blood pressure group(group Ⅲ,n=138),stabilizing at the normal high blood pressure group(group Ⅳ,n=498) and normal blood pressure or high-normal blood pressure progressing to hypertension group(group Ⅴ,n=241).The relationship between the changes in blood pressure and new carotid artery plaque was analyzed.Results:The detection rate of new carotid artery plaque in normal blood pressure population was higher than that in high normal blood pressure population(P<0.01).The detection rates of new carotid artery plaque in the group Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ were 18.9%,14.3%,17.1%,24.2 and 26.4%,respectively.With the increasing of blood pressure level,the detection rate of new carotid artery plaque showed an increasing trend(P<0.05).After adjusting the other risk factors,compared to the group Ⅱ,the RR value(95%CI) of new carotid artery plaque in group Ⅳ and Ⅴ were 2.007(1.162 to 3.464) and 1.823(1.009 to 3.291),respectively.Conclusions:Among non-hypertension people,the detection rate of carotid artery plaque increases with the increasing of blood pressure.Compared with the normal blood pressure progressing to high-normal blood pressure people,the risk of atherosclerosis increases in blood pressure stabilizing at high-normal level people.

关 键 词：颈动脉斑块 血压变化 队列研究 

分 类 号：R543.4[医药卫生—心血管疾病]