颈动脉粥样硬化与血压变异的关系

目的 探讨原发性高血压(EH)患者颈动脉粥样硬化(CAS)与血压变异(BPV)之间的关系. 方法 对125例伴CAS的EH患者(CAS组)与99例非颈动脉粥样硬化(NCAS)的EH患者(NCAS组)进行动态血压监测(ABPM),并检测血糖、血脂等生化指标. 结果 不同性别之间CAS的患病率无统计学差异,但患病率随年龄增加而增加(P ＜0.05)；CAS患病率与空腹血糖(FBG)、餐后2h血糖(2 hPG)、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C)显著相关(P ＜0.05)；CAS与24h平均收缩压(SBP)、24h平均舒张压(DBP)、24h收缩压标准差(SSD)、24h舒张压标准差(DSD)等动态血压有关(P＜0.05).多因素logistic回归分析显示,24 hSBP、24 h SSD均是CAS的独立危险因素(OR分别为1.219,1.587,均P＜0.05). 结论 EH患者CAS的发生与BPV具有相关性,尤其是与24 h SSD独立相关,加强动态血压监测对指导临床治疗具有重要意义.

Relationship between carotid atherosclerosis and blood pressure variability in patients with essential hypertension

Objective To explore the relationship between carotid atherosclerosis(CAS) in patients with essential hypertension(EH) and blood pressure variability(BPV).Methods The ambulatory blood pressure monitoring was carried out in 125 cases of EH associated with carotid atherosclerosis(CAS group) and 99 cases of EH not associated with carotid atherosclerosis(NCAS group),and biochemical indicators including blood sugar and lipid were detected.Results There was no significant difference in genders,while the prevalence of CAS was positively associated with age(P<0.05).CAS was correlated with fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C)(P<0.05).CAS was associated significantly with the indicators of ambulatory blood pressure including 24 h systolic blood pressure(SBP),24 h diastolic blood pressure(DBP),standard deviations of 24 h SBP and 24 h DBP(P<0.05).Multivariate logistic regression analysis showed that 24 hSBP and standard deviations of 24 h SBP were all independent risk factors of CAS(OR=1.219,1.587,P<0.05).Conclusion CAS is independently correlated with BPV in EH patients,especially with standard deviations of 24 h SBP.Strengthening the ambulatory blood pressure monitoring can contribute to guide the clinical treatment.