老年人动态脉压及脉压指数与颈动脉内膜中层厚度的相关性分析

目的探讨老年人动态脉压及脉压指数与颈动脉内膜中层厚度的关系。方法随机抽样调查65岁以上人群200人进行24h动态血压监测，监测患者的动态脉压（APP）水平，按APP≤40mmHg（46例）、41～60mmHg（66例）、61—80mmHg（61例）和〉80mmHg（27例）分为4组；按动态脉压指数（APPI）≤0．40（49例）、0．41—0．50（70例）、0．51～0．60（57例）和〉0．60（24例）分为4组。分别以彩色多普勒超声测定其颈动脉内膜中层厚度（IMT），并采集其静脉血测定血脂及高敏C-反应蛋白（hs—CRP）。结果随着APP及APPI的增加，颈动脉IMT明显增加，差异有统计学意义（P〈0．05）；Spearman相关分析，结果APP、APPI与颈动脉IMT呈正相关，其中以APPI相关系数（r）值大。结论动态脉压及脉压指数与颈动脉内膜中层厚度密切相关，且脉压指数在一定程度上较脉压在动脉硬化发展上有更大相关性。

Relationship between ambulatory pulse pressure, pulse pressure index and carotid intima media thickness in old subjectss

Objective To investigate the correlation of ambulatory pulse pressure （APP） and ambulatory pulse pressure index（APPI） with intima-media thickness（IMT） of carotid artery in old people. Methods To evaluate the value of APP and APPI within 24 hours in 200 senile patients chosen at random who are over 65 years old, whose PP and PPI level were measured by the dynamic blood pressure（BP） monitor. Those senile patients were divid- ed into 4 groups based on APP level,as APP ≤ 40 mmHg（46 cases） ,41-60 mmHg（66 cases） ,61-80 mmHg（61 cases） and APP 〉 80 mmHg （ 27 cases）. These cases were also further divided into 4 groups based on APPI level, as APPI ≤ 0.40 （ 49 eases ） ,0.41-0.50 （ 70 cases ）, 0.51-0.60 （ 57 cases ）, and APPI 〉 0.60 （ 24 cases ）. Intima-media thickness（IMT） of carotid artery, serum lipid and hs-CRP concentration were determined by Color Doppler Ultrasonography and immune turbidimetric assay,respectively. Results With the increase of APP and APPI, carotid IMT increased significantly, the difference was statistically significant （ P 〈 0.05 ）. Spearman correlation analysis showed that APP,APPI and carotid IMT were positively correlated. Conclusion There is a close correlation between APP, APPI and intima-media thickness of carotid artery. APPI is more correlated to the development of atherosclerosis than PP does.