高血压患者颈动脉亚临床病变与动态脉压指数及相关危险因素研究

目的探讨动态脉压指数（24h ambulatory pulse pressure index,24hAPPI）对原发性高血压（essentialhypertension,EH）患者颈动脉亚临床病变的影响。方法对255例EH患者进行动态血压监测（ambulatory blood pressure monitoring,ABPM）和颈动脉超声检查。所有患者分为3组：A组（PPI≤0.40）、B组（PPI：0.40～0.49）和C组（PPI≥0.50）。结果颈动脉斑块积分及颈动脉内膜中层厚度（intima media thickness,IMT）随着PPI的增加而增加,24hAPP、24hAPPI以及斑块的严重程度（颈动脉斑块积分）与IMT间呈相关性。多因素Logistic回归分析表明,24hAPP、24hAPPI、吸烟、高血压病程是颈动脉亚临床病变独立的预测指标。结论颈动脉斑块积分及颈动脉IMT随着PPI的增加而增加,24hPPI与动态PPI、斑块的严重程度与IMT间有相关性。24hAPP、24hAPPI、吸烟、高血压病程是颈动脉亚临床病变独立的预测指标。

The Relationship between Ambulatory Pulse Pressure Index and Subclinical Disease of Carotid Artery and the Related Risk Factors for Carotid Atherosclerosis in Hypertension Patients

Objective To study the relationship between 24h ambulatory pulse pressure index and subclinical disease of carotid artery in hypertension patients and to analyze the related risk factors of carotid atherosclerosis.Methods Two hundred and fifty five patients undergone ambulatory blood pressure monitoring(ABPM) and B-mode doppler ultrasonography,All patients were divided into three group:(PPI≤0.40),(PPI:0.40～0.49)和(PPI≥0.50).Results Age,hypertension course and cholesterol in three group was significantly increased.Carotid IMT and carotid plaques integral increased With 24hPPI rose,24hAPP correlated best with 24hAPPI in pearson correlated analysis,Carotid plaques integral correlated best with Carotid IMT in pearson correlated analysis,multiple logistic regression analysis showed that the 24hAPP,and 24hAPPI and smoking patients and long hypertension course were four increased independent predictors of carotid subclinical atheros-clerosis.Conclusion The higher the 24hAPPI,the worse the carotid artery subclinical atherosclerosis.The 24hAPP and 24hAPPI and long Hypertension course and smoking patients were four independent predictors of carotid IMT.