原发性高血压患者的血压昼夜节律、血压变异性与外周动脉粥样硬化的相关性  

Relationship between Circadian Rhythm,Blood Pressure Variability and Peripheral Atherosclerosis in Patients with Essential Hypertension

作　　者：黄颖睿 朱雪梅 聂淑璇 杨珊珊 HUANG Yingrui;ZHU Xuemei;NIE Shuxuan(Beijing University of Posts and Telecommunications Hospital,Beijing 100876)

机构地区：[1]北京邮电大学医院,北京100876

出　　处：《医学临床研究》2025年第2期228-231,共4页Journal of Clinical Research

摘　　要：【目的】探讨原发性高血压患者的血压昼夜节律、血压变异性与踝肱指数(ABI)的相关性。【方法】选择2021年9月至2023年12月在本院就诊的176例原发性高血压患者,根据ABI的检测结果将患者分为硬化组(n=90)和非硬化组(n=86),根据血压昼夜节律将患者分为杓型组(n=48)、非杓型组(n=94)和反杓型组(n=34)。比较非硬化组与硬化组动态血压指标[24 h收缩压(24hSBP)、日间收缩压(dSBP)、夜间收缩压(nSBP),以及24 h舒张压(24hDBP)、日间舒张压(dDBP)、夜间舒张压(nDBP)]、血压变异性指标[24 h收缩压标准差(24hSSD)、24 h舒张压标准差(24hDSD)、日间收缩压标准差(dSSD)、日间舒张压标准差(dDSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)],计算收缩压下降率(ΔSBP%)、舒张压夜间下降率(ΔDBP%)。采用Pearson分析血压昼夜节律与外周动脉粥样硬化的相关性,采用多因素Logistic回归分析外周动脉粥样硬化的影响因素。【结果】硬化组24hSBP、dSBP、nSBP、24hSSD、24hDSD、dSSD、nSSD、nDSD高于非硬化组,ΔSBP%低于非硬化组,差异有统计学意义(P<0.05)。非杓型组、反杓型组ABI显著低于杓型组,差异有统计学意义(P<0.05)。Pearson相关分析显示,ABI与ΔSBP%呈负相关(r=-0.406,P=0.044)。Logistic回归分析显示,24hSSD、nSSD升高是外周动脉粥样硬化发生的危险因素(P<0.05)。【结论】血压的异常昼夜节律及变异性是导致动脉粥样硬化的重要因素,而对血压变化的正确分析是预防和干预动脉粥样硬化的有效措施。【Objective】To investigate the relationship between blood pressure circadian rhythm,blood pressure variability and ankle-brachial index(ABI)in patients with essential hypertension.【Methods】A total of 176 patients with essential hypertension admitted to our hospital from September 2021 to December 2023 were selected and divided into sclerotic group(n=90)and non-sclerotic group(n=86)according to the detection results of anklebrachial index(ABI).Patients were divided into arytenoid group(n=48),non-arytenoid group(n=94)and reverse arytenoid group(n=34)according to circadian rhythm of blood pressure.The non-sclerotic group and the sclerotic group were compared in terms of the ambulatory blood pressure index[24 h systolic blood pressure(24hSBP),daytime systolic blood pressure(dSBP),night systolic blood pressure(nSBP),and 24 h diastolic blood pressure(24hDBP),daytime diastolic blood pressure(dDBP),night diastolic blood pressure(nDBP)]and the indicators of blood pressure variability[24 h standard deviation of systolic blood pressure(24hSSD),24 h standard deviation of diastolic blood pressure(24hDSD),standard deviation of diastolic blood pressure(dSSD),standard deviation of diastolic blood pressure(dDSD),standard deviation of nocturnal systolic blood pressure(nSSD),standard deviation of nocturnal diastolic blood pressure(nDSD)].The decreasing rate of systolic blood pressure(ΔSBP%)and the decreasing rate of diastolic blood pressure at night(ΔDBP%)were calculated.Pearson was used to analyze the correlation between circadian rhythm of blood pressure and peripheral atherosclerosis,and multiple Logistic regression was used to analyze the influencing factors of peripheral atherosclerosis.【Results】24hSBP,dSBP,nSBP,24hSSD,24hDSD,dSSD,nSSD,nDSD in hardening group were higher than those in non-hardening group,andΔSBP%was lower than that in non-hardening group,the difference was statistically significant(P<0.05).ABI of non-arytenoid group and reverse arytenoid group was significantly lower than that of arytenoid group,

关 键 词：原发性高血压 血压 昼夜节律 踝肱指数 

分 类 号：R544.1[医药卫生—心血管疾病]