中老年原发性高血压患者脉压指数与颈动脉内膜中层厚度的关系

目的 探讨中老年原发性高血压（高血压）患者脉压指数（pulse pressure index,PPI）与颈动脉内膜-中层厚度（intima-media thickness,IMT）的相关性.方法 从自2010年开始在东莞市寮步镇已完成户籍管理的高血压患者库中随机（电脑随机数字表法）选取完成超声心动图和颈动脉超声检查的中老年高血压患者342例.根据PPI≤0.4、0.4＜PPI≤0.5、0.5＜PPI≤0.6及PPI＞0.6分成4组;分析各组人群中PPI与颈动脉IMT之间的关系.结果 342例患者纳入本研究,其中男149例,女193例,年龄（63.0±11.4）岁.随着PPI的增加,年龄、收缩压随之增加,舒张压随之减少,差异具有统计学意义（P＜0.05）;通过绘制箱图,得出颈动脉IMT随着PPI的增加而增加,差异有统计学意义（P=0.000）.以IMT为检测变量,PPI分组为状态变量,定义状态变量为1,建立受试者工作曲线,曲线下面积=0.783 （P=0.000）,有较好的预测价值,PPI =0.40时所对应的特异度与敏感度之和最大,特异度为92.7.0％,敏感度60.8％.结论 中老年高血压患者PPI与颈动脉IMT之间成正相关.

Relation between pulse pressure index and carotid intima-media thickness in middle-aged and elderly patients with essential hypertension

Objectives To investigate the relationship between pulse pressure index （PPI） and carotid intima-media thickness （IMT） in middle-aged and elderly patients with essential hypertension.Methods Totally 342 middle-aged and elderly patients with essential hypertension who had completed the household registration management of hypertension and had performed echocardiography and carotid ultrasound examination,were selected since 2010.According to PPI ≤0.4,0.4〈PPI≤0.5,0.5〈PPI≤0.6 and PPI〉0.6,the patients were divided into 4 groups.PPI and carotid IMT among the 4 groups were analyzed and compared.Results There were 342 patients included in this study,among which 149were male,193 were female,with an average age of （63.0±11.4） years.With the increase of PPI,age and systolic blood pressure increased,while diastolic pressure decreased,the difference had statistical significance （P〈0.05）.By mapping the box-plot,it was concluded that carotid IMT increased with the increase of PPI,and the difference was statistically significant （P=0.000）.The receiver operating characteristic （ROC） curve was built with IMT as detection,PPI group as state variable and state variable was 1.The area under the curve （AUC）=0.783 （P=0.000）,which had a good predictive value.When PPI=0.40,the sum of specificity and sensitivity was maximum,which was 92.70% and 60.8% respectively.Conclusions There is a positive correlation between PPI and carotid IMT in middle-aged and elderly patients with essential hypertension.