高血压病患者颈动脉斑块及冠心病与血压变异性的关系

目的 探讨高血压病患者颈动脉斑块及冠心病与血压变异性的关系.方法 选取原发性高血压患者126例,行24h动态血压、颈动脉超声、冠状动脉造影或冠状动脉CT检查.根据颈动脉超声结果分为颈动脉斑块组(64例)和非斑块组(62例),根据冠状动脉造影或冠状动脉CT检查结果分为冠心病组(77例)和非冠心病组(49例),分别比较血压变异系数与颈动脉斑块及冠心病的关系.结果 ①颈动脉斑块组SBP平均值及变异系数与非斑块组的差异有统计学意义[SBP平均值:(145±15) mm Hg比(116±10)mm Hg(1 mm Hg=0.133 kPa),变异系数:(0.09±0.03)比(0.07±0.01),P＜0.05],而组间DBP平均值及变异系数的差异无统计学意义(P＞0.05).②冠心病组SBP变异系数和DBP平均值与非冠心病组的差异有统计学意义[SBP变异系数:(0.09±0.02)比(0.07±0.02),DBP平均值:(68±6)mm Hg比(71±6)mm Hg,P＜0.05],组间SBP平均值及DBP变异系数的差异无统计学意义(P＞0.05).③SBP变异系数与冠心病相关(r=3.719,P=0.025).结论 血压变异系数尤其是SBP变异系数是颈动脉斑块及冠心病发病的危险因素.

Association between blood pressure variability and carotid artery plaque and coronary artery diseas in pri- mary hypertension patients

Objective To investigate the association between blood pressure variability and carotid/coro- nary artery atherosclerosis in hypertension patients. Methods All 126 primary hypertension patients admitted in our hospital from October 2010 to October 2012 were enrolled; results of 24 h ambulatory blood pressure, carotid ar- tery ultrasound and coronary arteriography were recorded and analysed. Results （1）24 h ambulatory blood pressure and carotid artery plaque： the average systolic pressure and systolic variation were significantly higher compared with carotid artery atherosclerosis negative group [ （ 145 ± 15）mm Hg vs （ 116 ± 10）mm Hg （ 1 mm Hg = 0. 133 kPa）, （0.09 ± 0.03 ） vs （0.07 ±0.01 ）, all P 〈 0.05 ], while the average diastolic pressure and diastolic variation were not different between the two groups （ P 〉 0.05 ） ; @24 h ambulatory blood pressure and coronary artery diseas ： sys- tolic variation and diastolic pressure were significantly higher compared with group without coronary artery disease [ （0.09 ±0.02） vs （0.07 ± 0.02）, （68 ± 6） mm Hg vs （71 ± 6） mm Hg, all P 〈 0.05 ], while the diastolic varia- tion were not different between these two groups （ P 〉 0.05） ; logistic regression analysis indicated that systolic varia- tion was associated with coronary artery disease（r = 3. 719, P = 0. 025）. Conclusion Blood pressure variability es- pecially systolic variation is associated with carotid artery atherosclerosis and coronary disease.