老年人群体位性血压变化与亚临床动脉粥样硬化关系探讨  

DISCUSS RELATIONSHIP BETWEEN ORTHOSTATIC BLOOD PRESSURE CHANGES AND SUBCLINICAL ATHEROSCLEROSIS IN ELDERLY POPULATION

作　　者：张莹 杜鑫[2] 李劼 吴寿岭[2] 马琳 张树华 季春鹏[2] 施继红[2] 郭蕊 ZHANG Ying;DU Xin;LI Jie;WU Shouling;MA Lin;ZHANG Shuhua;JI Chunpeng;SHI Jihong;GUO Rui(Ultrasound Department,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院超声科,河北省唐山市063000 [2]开滦总医院心内科 [3]华北理工大学附属医院科教科

出　　处：《中国煤炭工业医学杂志》2021年第1期25-28,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题计划项目(编号:20191131)。

摘　　要：目的探讨老年人群体位性血压变化与亚临床动脉粥样硬化的关系。方法选取参加2019年度开滦总医院健康查体的老年人群(年龄≥60岁),所有患者均行颈动脉超声检查、卧-立位血压测量及基本生化指标检测。采用多因素Logistic回归方法分析体位性血压改变与亚临床动脉粥样硬化-颈动脉内中膜厚度(CIMT)增厚的关系。结果经过纳入标准及排除标准筛选,共有827例纳入统计分析,根据CIMT厚度分为观察组(CIMT增厚)593例,对照组(无CIMT增厚)234例,其基本资料比较,性别、收缩压、空腹血糖及尿酸指标差异均有统计学意义(均P<0.05);采用χ2检验对观察组和对照组间体位性血压改变进行分析,差异有统计学意义(P<0.05);以CIMT增厚为因变量,体位性血压改变为自变量,采用多因素Logistic回归分析结果显示,CIMT增厚与体位性低血压具有相关性,体位性低血压者发生CIMT增厚的危险性增加近3倍。结论体位性低血压为老年人群亚临床动脉粥样硬化的独立危险因素。Objective To investigate the correlations of Orthostatic Blood Pressure Changes and subclinical atherosclerosis in elderly population.Methods In 2019,all the elderly people(age≥60)who took part in the physical examination of Kailuan General Hospital were examined by carotid ultrasound,the blood pressure of supine-standing position and the basic biochemical indexes.Multivariate Logistic regression was used to analyze the relationship between Orthostatic Blood Pressure Changes and subclinical atherosclerotic-CIMT thickening.Results A total of eight hundred and twenty seven people were included in the statistical analysis.According to the thickness of CIMT,they were divided into observation group(CIMT thickening)and control group(no CIMT thickening).There were significant differences in sex,systolic blood pressure,fasting blood glucose and uric acid between the two groups(P<0.05);χ~2 test was used to analyze the Orthostatic Blood Pressure Changes between the observation group and the control group.The results were statistically significant(P<0.05);With CIMT thickening as dependent variable and Orthostatic Blood Pressure Changes as independent variable,multivariate Logistic regression analysis showed that CIMT thickening was correlated with Orthostatic hypotension,risk of CIMT thickening in patients with Orthostatic hypotension increased nearly fourfold.Conclusion Orthostatic hypotension is an independent risk factor for subclinical atherosclerosis in the elderly.

关 键 词：体位性血压改变 亚临床动脉粥样硬化 体位性低血压 颈动脉内中膜厚度 

分 类 号：R544[医药卫生—心血管疾病]