原发性高血压合并颈动脉硬化者的动态血压特点及相关因素分析

目的 分析原发性高血压（essential hypertension，EH）合并颈动脉硬化患者的动态血压特点，探讨动态血压相关参数与颈动脉硬化的关系。方法 选取2019年8月至2021年8月镇江市第一人民医院收治的患者115例为研究对象，根据是否合并颈动脉硬化分为颈动脉正常组（n=44）和颈动脉硬化组（n=71），行24h动态血压检测，对比两组动态血压参数的差异，分析其与颈动脉硬化的关系。结果 与颈动脉正常组相比，颈动脉硬化组各时段的收缩压、脉压差、收缩压标准差均增大，夜间收缩压下降率降低，非杓型血压占比升高，差异均有统计学意义（P<0.05）。相关性分析发现，颈动脉硬化与各时段的收缩压标准差呈正相关，与夜间收缩压下降率呈负相关，差异均有统计学意义（P<0.05）。回归分析显示，年龄、夜间收缩压标准差是EH合并颈动脉硬化的独立影响因素，差异有统计学意义（P<0.05）。结论 异常的血压变异性及血压昼夜节律对EH患者发生颈动脉硬化有影响。

Analysis of ambulatory blood pressure characteristics and related factors in patients with essential hypertension complicated with carotid arteriosclerosis

Objective To analyze the characteristics of ambulatory blood pressure in patients with essential hypertension (EH) complicated with carotid arteriosclerosis, and to explore the relationship between ambulatory blood pressure parameters and carotid arteriosclerosis. Methods A total of 115 patients with EH admitted to Zhenjiang First People''s Hospital from August 2019 to August 2021 were selected for this study. According to carotid ultrasound patients were divided into normal carotid artery group (n=44) and carotid arteriosclerosis group (n=71). 24h ambulatory blood pressure monitoring (ABPM) was performed to compare the differences of ambulatory blood pressure parameters between the two groups and analyze their relationship with carotid arteriosclerosis. Results Compared with the normal carotid group, systolic blood pressure (SBP), pulse pressure difference (PP) and systolic blood pressure standard deviation (SSD) of 24h, daytime and nighttime in carotid arteriosclerosis group were higher; nocturnal systolic blood pressure decline rate (nSBPF) was decreased, the detection rate of non dipper blood pressure was increased, all differences were statistically significant (P<0.05). Correlation analysis showed that carotid arteriosclerosis was positively correlated with the SSD in each period, it was negatively correlated with nSBPF, all differences were statistically significant (P<0.05). Logistic regression analysis showed that age and night SSD were the influencing factors of carotid arteriosclerosis, the differences was statistically significant (P<0.05). Conclusion The changes of blood pressure variability (BPV) and circadian rhythm of blood pressure are closely related to carotid arteriosclerosis in patients with EH.