动态动脉硬化指数的影响因素和对靶器官损害的研究

目的 探讨原发性高血压患者动态动脉硬化指数（AASI）的相关因素和对靶器官损害的关系及其临床意义。方法 行24h动态血压（ABPM）监测并计算AASI的原发性高血压患者330例，依据AASI结果分为低AASI组（n=167）及高AASI组（n=163），记录2组患者的一般临床资料、动态血压相关指标、冠状动脉造影结果、左室质量指数（LVMI）、估算肾小球滤过率（eGFR）及踝臂指数（ABI）。结果 高AASI组在年龄（64.91±9.70vs59.12±10.00）、合并糖尿病比例（33.8%vs14.8%）、非杓型血压比例（65.6% vs43.7%）、24 h脉压（PP）(65.27±11.31 vs56.06±10.51)、24 h舒张压标准差（DBPSD）(9.64±2.47 vs8.31±2.31)、冠状动脉病变支数（1.78±1.10 vs1.27±1.07）、LVMI（125.74±29.65 vs107.69±23.23）、外周血管病变（27.3% vs16.4%）大于低AASI组；高AASI组eGFR水平小于低AASI组（85.31±20.31 vs 99.67±17.76）。相关分析显示AASI与冠脉病变数(r=0.235)、LVMI(r=0.168)、外周血管病变(r=0.167)呈正相关，与eGFR(r=-0.187)呈负相关；多元线性回归分析显示年龄、糖尿病、PP、DBPSD、非杓型血压是AASI的预测因素。结论 AASI受年龄、糖尿病、PP、血压变异性及血压杓型的影响，其升高和原发性高血压患者出现心、肾及外周血管疾病有关，有助于临床医生评估高血压患者并发症的发生和发展。

Relationship between Ambulatory Arterial Stiffness Index and Target Organ Damage in Primary Hypertensive Patients

Objective To investigate the correlative factors of ambulatory arterial stiffness index (AASI) and the relationship with target organ damage (TOD) in primary hypertensive patie- nts. Methods A total of 330 hypertensive inpatients were included in the study and divided into two groups according to the AASI:low AASI group (n=167) and high AASI group(n=163).AASI was calculated obtained from 24-hour ambulatory blood pressure monitor (ABPM). The clinical data were collected including general information ,the data of ABPM, coronary lesions,left ventricular mass index (LVMI), estimated glomerular filtration rate(eGFR) and ankle brachial index(ABI) to compare between the groups.Results The levels of age(64.91±9.70vs59.12± 10.00) ,the proportion of diabetes(33.8%vs14.8%), the proportion of non-dipper(65.6% vs43.7%), 24 hours pulse pressure (PP)(65.27±11.31 vs56.06±10.51),24 hours diastolic blood pressure standard deviation（DBPSD)( 9.64±2.47 vs8.31±2.31), LVMI(125.74±29.65 vs107.69±23.23), coronary lesions(1.78±1.10 vs1.27±1.07) and the proportion of periphreral vascular disease(27.3% vs16.4%) were higher in the high AASI group than those in the low group ( P<0.01) ,the levels of eGFR(85.31±20.31 vs99.67±17.76) were inverse.In the correlation analysis,AASI was positively associated with coronary lesions (r=0.235), LVMI(r=0.168), periphreral vascular disease(r= 0.167),negatively with eGFR(r=-0.187).In multiple linear regression analysis model,independent predictors of AASI were age,diabetes, PP, DBPSD,non-dipper.Conclusion AASI correlated with age, diabetes,PP and blood pressure variability, non-dipper. The higher level of AASI may relate to the development of TOD in primary hypertensive inpatients.