老年高血压患者血压变异性的影响因素研究  

Analysis of influence factors of blood pressure variability in elderly hypertensive patients

作　　者：曲歌乐[1] 张仲迎[1] 魏占云[1] 王紫晨[1] Qu Geyue;Zhang Zhongying;Wei Zhanyun;Wang Zichen(Department of General Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院综合科,北京100053

出　　处：《北京医学》2020年第12期1169-1173,共5页Beijing Medical Journal

摘　　要：目的探讨老年高血压患者血压变异性(blood pressure variability,BPV)的影响因素。方法选取2018年1—12月于首都医科大学宣武医院住院的184例老年原发性高血压患者,均进行动态血压监测,并收集资料,以24 h、日间、夜间3个时间段的收缩压变异系数(SBP_CV)及舒张压变异系数(DBP_CV)作为衡量BPV的指标,比较不同特征的老年高血压患者的BPV,采用多元线性回归分析研究老年高血压患者BPV的影响因素。结果高龄老人(年龄≥80岁)的24 h及日间SBP_CV、DBP_CV均高于年轻老人(年龄<80岁),而夜间SBP_CV、DBP_CV均低于年轻老人,仅夜间DBP_CV在两组间的差异有统计学意义(P<0.05);男性24 h及日间SBP_CV、DBP_CV均低于于女性,夜间SBP_CV、DBP_CV均高于女性,但差异无统计学意义;合并糖尿病或冠心病的老年高血压患者24 h、日间及夜间SBP_CV、DBP_CV均高于未合并糖尿病或冠心病的老年高血压患者,仅夜间DBP_CV在冠心病两组之间的差异有统计学意义(P<0.05);使用CCB类降压药物的患者BPV最低,使用ARB/ACEI类药物的患者BPV最高,但上述各组间的差异无统计学意义(P>0.05)。多元线性回归分析结果显示,年龄、冠心病病史与NDBP_CV显著相关(P<0.05)。结论年龄、冠心病病史均与NDBP_CV存在一定程度的相关关系,BPV随着年龄增高而增大,合并冠心病的患者BPV有增大趋势。Objective To investigate the influence factors of blood pressure variability(BPV)in elderly hypertensive patients.Methods One hundred and eighty-four elderly hypertensive patients who underwent ABPM were selected and their clinical data were collected.The systolic blood pressure variation coefficient(SBP_CV)and diastolic blood pressure variation coefficient(DBP_CV)of 24 hours,daytime and nighttime were used as BPV indicators.BPV was compared in elderly hypertensive patients with different characteristics.Influence factors for BPV were explored by multiple linear regression.Results The SBP_CV and DBP_CV of group≥80 years old were higher than those of group<80 years old in 24 hours and in daytime,while lower at night,only the difference of NDBP_CV between the two groups was statistically significant(P<0.05).The SBP_CV and DBP_CV of men were lower than those of women in 24 hours and daytime,while higher at night.The SBP_CV and DBP_CV of the elderly hypertension patients with diabetes or coronary heart disease were higher than those of the elderly hypertension patients without these diseases,only the difference of NDBP_CV between the two coronary heart disease groups was statistically significant(P<0.05).BPV of patients who used CCB drugs was the lowest,and BPV of patients who used ARB/ACEI drugs was the highest.The results of multiple linear regression analysis showed that age and history of coronary heart disease had significant correlations with NDBP_CV.Conclusions There is a certain degree of correlation between age,history of coronary heart disease and DBP_CV at night.BPCV increases with age,also increased in patients with coronary heart disease.

关 键 词：血压变异性 老年高血压 24 h动态血压监测 影响因素 

分 类 号：R544.1[医药卫生—心血管疾病]