apoB/apoA1比值与原发性高血压患者血压变异性的相关性  

The correlation between apoB/apoA1 ratio and blood pressure variability in patients with essential hypertension

作　　者：王丽霞[1] 李盈[1] 韩拓 惠静[1] 王怡雯 王聪霞[1] 张岩[1] WANG Li-xia;LI Ying;HAN Tuo;HUI Jing;WANG Yi-wen;WANG Cong-xia;ZHANG Yan(Department of Cardiology,the Second Afiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shanxi,China)

机构地区：[1]西安交通大学第二附属医院心血管内科,陕西西安710004

出　　处：《广东医学》2022年第11期1371-1376,共6页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(82100359)。

摘　　要：目的分析原发性高血压患者血脂相关指标apoB/apoA1比值与血压变异性(BPV)之间的相关性,旨在阐明血脂对BPV的影响。方法入选心内科住院的符合纳排标准的原发性高血压患者共153例,年龄(56.8±10.4)岁,男性41例(26.8%)。入院后收集患者的一般资料、肝肾功、血脂、血糖等实验室相关指标。依据apoB/apoA1比值中位数将研究对象分为两组,低apoB/apoA1组(apoB/apoA1<0.72)和高apoB/apoA1组(apoB/apoA1≥0.72)。两组分别行24 h动态血压监测,以动态血压标准差作为BPV的指标。两组间进行基线资料、实验室指标和动态血压指标的比较。Spearman相关性及多元线性回归评估apoB/apoA1比值与BPV的关系。结果与低apoB/apoA1组相比,高apoB/apoA1组24 h舒张压(24hDBP)、白天收缩压(dSBP)、白天舒张压(dDBP)、24 h收缩压标准差(24hSSD)、24 h舒张压标准差(24hDSD)、白天舒张压标准差(dDSD)、夜间舒张压标准差(nDSD)较大[24hDBP:(81.0±8.5)vs(84.0±9.4)mmHg,P=0.049;dSBP:(133.0±12.5)vs(138.1±14.3)mmHg,P=0.031;dDBP:(81.6±9.0)vs(85.8±10.0)mmHg,P=0.018;24hSSD:(13.6±2.9)vs(15.0±3.7)mmHg,P=0.045;24hDSD:(9.4±2.3)vs(10.8±2.3)mmHg,P<0.001;dDSD:(9.1±2.7)vs(10.0±2.3)mmHg,P=0.013;nDSD:(8.6±2.8)vs(10.1±3.2)mmHg,P=0.002],而非杓型高血压患者比例较少(93.4%vs 74.0%,P=0.001)。相关性分析显示,apoB/apoA1比值与24hDSD(r=0.310,P<0.001)、dDSD(r=0.177,P=0.028)、nDSD(r=0.220,P=0.006)呈正相关。多元线性回归分析显示,apoB/apoA1与24hDSD、dDSD、nDSD升高密切相关(P<0.05)。结论apoB/apoA1比值与原发性高血压BPV增加有关,高血压患者应同时做好血脂管理。Objective To analyze the correlation between apoB/apoA1 ratio and blood pressure variability(BPV),so as to clarify the impact of serum lipids on BPV in patients with essential hypertension.Methods A total of 153 patients(41 males,26.8%)with essential hypertension were enrolled.The average age of enrolled patients was(56.8±10.4)years.The general data,liver function,kidney function,serum lipids,blood glucose and other laboratory indicators of the patients were collected.Patients were grouped by median of apoB/apoA1 ratio,low apoB/apoA1 group(apoB/apoA1<0.72)and high apoB/apoA1 group(apoB/apoA1≥0.72).A 24 h-hour ambulatory blood pressure monitoring was carried out in each group.The standard deviations of ambulatory blood pressure was used as an indicators of BPV.Baseline data,laboratory indexes and ambulatory blood pressure were compared between the two groups.Spearman correlation and multiple linear regression were used to evaluate the correlation between apoB/apoA1 ratio and BPV.Results Compared with the low apoB/apoA1 group,24 h diastolic blood pressure(24 hDBP),daytime systolic blood pressure(dSBP),daytime diastolic blood pressure(dDBP),24 h systolic blood pressure standard deviation(24 hSSD),24 h diastolic blood pressure standard deviation(24 hDSD),daytime diastolic blood pressure standard deviation(dDSD),nighttime diastolic blood pressure standard deviation(nDSD)were significantly higher in the high apoB/apoA1 group(24 hDBP:(81.0±8.5)mmHg vs.(84.0±9.4)mmHg,P=0.049;dSBP:(133.0±12.5)mmHg vs.(138.1±14.3)mmHg,P=0.031;dDBP:(81.6±9.0)mmHg vs.(85.8±10.0)mmHg,P=0.018;24 hSSD:(13.6±2.9)mmHg vs.(15.0±3.7)mmHg,P=0.045;24 hDSD:(9.4±2.3)mmHg vs.(10.8±2.3)mmHg,P<0.001;dDSD:(9.1±2.7)mmHg vs.(10.0±2.3)mmHg,P=0.013;nDSD:(8.6±2.8)mmHg vs.(10.1±3.2)mmHg,P=0.002);but the proportion of non-dipper type hypertension was significantly smaller(93.4%vs.74.0%,P=0.001).Correlation analysis showed that apoB/apoA1 ratio was positively correlated with 24 hDSD(r=0.310,P<0.001),dDSD(r=0.177,P=0.028),nDSD(r=0.220,P=0.006)respe

关 键 词：apoB/apoA1比值 血压变异性 24 h舒张压标准差 白天舒张压标准差 夜间舒张压标准差 

分 类 号：R544.1[医药卫生—心血管疾病] R446.1[医药卫生—内科学]