长时血压变异性对动脉硬化的影响研究  

Effects of Long-term Blood Pressure Variability on Arteriosclerosis

作　　者：武爱萍[1] 马一涵 李兴雨 韩旭 刘倩 宋永健 李国 吴寿岭[1] 吴云涛[1] WU Aiping;MA Yihan;LI Xingyu;HAN Xu;LIU Qian;SONG Yongjian;LI Guo;WU Shouling;WU Yuntao(Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China;Graduate School,North China University of Science and Technology,Tangshan 063000,China;Department of Gastroenterology,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;Department of Cardiology,Luanzhou People's Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院心内科,河北省唐山市063000 [2]华北理工大学研究生院,河北省唐山市063000 [3]华北理工大学附属医院消化内科,河北省唐山市063000 [4]滦州市人民医院心内科,河北省唐山市063000

出　　处：《中国全科医学》2021年第2期148-153,共6页Chinese General Practice

摘　　要：背景长时血压变异性是心脑血管疾病重要的独立危险因素,目前长时血压变异性如何导致心脑血管疾病的发生发展尚不明确,且国内尚未见有关长时血压变异性与动脉硬化关系的研究。目的探究长时血压变异性对动脉硬化的影响。方法选取完成2006、2008、2010年度开滦集团健康体检以及臂踝脉搏波传导速度(baPWV)测量的21420例体检者为调查对象,收集其体质指数(BMI)、心率(HR)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FBG)、血压、baPWV,并计算收缩压标准差(SBP_SD)。将调查对象按SBP_SD情况分为第一分位组(7188例)、第二分位组(7102例)、第三分位组(7130例),比较组间异质性,通过多元线性回归分析SBP_SD与baPWV的关系,采用多因素Logistic回归分析探讨不同SBP_SD水平对动脉硬化发生的影响。结果第二分位组调查对象年龄、SBP_SD、baPWV、BMI、2006年度收缩压(SBP06)、2008年度收缩压(SBP08)、2010年度收缩压(SBP10)、FBG、LDL水平高于第一分位组,第三分位组调查对象年龄、SBP_SD、baPWV、BMI、HR、SBP06、SBP08、SBP10、FBG、LDL水平高于第一分位组和第二分位组(P<0.05)。多元线性回归分析显示,SBP_SD是baPWV的影响因素(P<0.05)。多因素Logistic回归分析显示,SBP_SD是发生动脉硬化的影响因素(P<0.05)。且在非高血压人群及高血压人群中,SBP_SD仍是baPWV及发生动脉硬化的影响因素(P<0.05)。结论长时血压变异性可能导致动脉硬化的发生,是动脉硬化的危险因素。Background Long-term blood pressure variability(BPV)is an important independent risk factor for cardiovascular disease.It is unclear how long-term BPV contributes to the development of cardiovascular disease.There are no studies on the relationship between long-term BPV and arterial stiffness in China.Objective To investigate the effect of longterm BPV on arteriosclerosis.Methods A total of 21420 eligible workers of Kailuan Group who attended annual staff physical examinations(2006,2008 and 2010)with complete data of examinations were recruited.Data were collected,such as body mass index(BMI),low-density lipoprotein(LDL),high-density lipoprotein(HDL),fasting blood glucose(FBG),blood pressure,brachial-ankle pulse wave velocity(baPWV),and calculated standard deviation of systolic blood pressure(SBP_SD).The differences across tertiles groups of SBP_SD〔low SBP_SD group(n=7188),medium SBP_SD group(n=7102),and high SBP_SD group(n=7130)〕were analyzed.The relationship between SBP_SD and baPWV was analyzed by multiple linear regression.Multivariate Logistic regression analysis was used to investigate the association of SBP_SD with arteriosclerosis.Results Compared with low SBP_SD group,medium SBP_SD group had greater average age,higher average SBP_SD,baPWV,BMI,FBG and LDL,and higher average SBP in 2006,2008 and 2010(P<0.05),and high SBP_SD group showed higher average SBP_SD,baPWV,BMI,hear rate,FBG and LDL,and higher average SBP in 2006,2008 and 2010(P<0.05).Multiple linear regression analysis showed that SBP_SD was an influential factor of baPWV(P<0.05).Multivariate logistic regression analysis showed that SBP_SD was an influential factor in the occurrence of arteriosclerosis(P<0.05).SBP_SD remained an influential factor in baPWV and the development of arteriosclerosis in both non-hypertensive and hypertensive groups(P<0.05).Conclusion Long-term BPV may be a risk factor for arteriosclerosis,which may cause arteriosclerosis.

关 键 词：动脉硬化 长时血压变异性 心血管疾病 脑血管疾病 收缩压标准差 影响因素分析 

分 类 号：R543.5[医药卫生—心血管疾病]