老老年高血压患者血压昼夜节律与血小板分布宽度相关性研究

目的 探讨老老年原发性高血压患者血压昼夜节律与血小板分布宽度（PDW）的相关性.方法 选择中国中医科学院广安门医院2013年8月至2014年1月心内科住院的老老年高血压患者100例,男性41例,女性59例,平均年龄（82.60±2.37）岁.根据血压昼夜节律的不同,将患者分为3组,杓型组24例,非杓型组26例,反杓型组50例.比较三组患者血小板分布宽度,分析其影响因素.结果 三组间PDW值比较,杓型组（9.85±1.25）％＜非杓型组（11.84±1.56）％＜反杓型组（12.12±1.82）％,差异有统计学意义（P＜0.01）.经多元线性逐步回归分析显示,昼夜血压节律和丙氨酸转氨酶（ALT）为PDW的影响因素.结论 老老年高血压患者的血压昼夜节律与PDW关系密切,诊治中应重视PDW的监测,调节血压昼夜节律,改善患者自主神经功能,早期干预,防止急性心脑血管事件并改善预后。

Correlation study between the platelet distribution width and blood pressure circadian rhythm in very elderly patients with hypertension

Objective To investigate the correlation between very elderly essential hypertensive （EH） pa- tients＇circadian rhythms and platelet distribution width. Methods Select very elderly patients with EH in cardio- vascular department of GuangAnmen Hospital attached to China Academy of Traditional Chinese Medicine, from July 2013 to January 2014. Totally 100 cases, 41 males and 59 females, average age （82.60±2.37）years old. De- pending on the circadian rhythm, the patients were divided into three groups, 24 cases dippers, 26 cases of non- dipper group, anti- dipper group 50 cases. The platelet distribution width （PDW） of these groups and analysis ef- fective factors of PDW were compared. Results The three groups PDW value comparison, dipper group （9.85±1.25）%〈 non-dipper group （11.84±1.56）%〈 Anti-dipper group （12.12±1.82）%, the difference was statistically significant （P〈0.01）. Multiple linear regression analysis showed that circadian rhythm and ALT were factors of PDW. Conclusion There were intense relationship between blood pressure circadian rhythm and PDW in very elderly hypertensive patients. We should pay attention PDW monitoring, blood pressure circadian rhythms regulating, autonomic function improving in the process of diagnosis and treatment of very elderly hypertensive patients in order to intervene early and prevent acute cardiovascular and cerebrovaseular events or improve prognosis.