社区老年高血压患者血压晨峰与颈动脉粥样硬化、微量蛋白尿的相关性研究

目的 探讨血压晨峰（morning blood pressure surge,MBPS）与颈动脉硬化、微量蛋白尿（Micro albuminuria,MAU）的关系.方法 对入选的160例老年高血压患者进行24 h动态血压监测,根据监测结果分为晨峰组（n=86）和非晨峰组（n=74）,并对两组患者均进行颈动脉超声检查,测量颈总动脉内膜中层厚度（CCA-IMT）,观察有无斑块形成,比较两组患者CCA-IMT、颈动脉斑块的差别.所有对象于血压监测次日进行晨MAU、血糖和肾功能检测,观察两组间的差别.结果 晨峰组CCA-IMT显著＞非晨峰组（P＜0.05）;CCA-IMT与年龄、24h平均收缩压、空腹血糖和血压晨峰呈正相关（P＜0.01）;与非晨峰组比较,晨峰组颈动脉斑块严重程度明显增高.晨峰组MAU、尿酸与非晨峰组比较差异均有统计学意义（P＜0.05）.MAU与年龄、血压晨峰、血糖及尿酸呈正相关（P＜0.05）.结论 血压晨峰与颈动脉粥样硬化、MAU有关,在治疗高血压的同时重视晨峰血压的控制有重要意义.

The Association between Morning Blood Pressure Surge and Carotid Atherosclerosis,Micro Albuminuria in Patients with Essential Hypertension

OBJECTIVE To investigate the association between morning blood pressure surge（MBPS）and carotid atherosclerosis, Micro albuminuria（MAU）in patients with essential hypertension. METHODS According to the results of 24 h ambulatory blood pressure monitoring, 160 patients were classified as the morning BP surge group（MBPS group, n=86）, and non-surge group（NMBPS group, n=74）. Patients underwent carotid ultrasound, the intima-medial thickness （CCA-IMT） , plaques and MAU were examined. RE- SULTS The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group（P〈0.05） ; Pearson relation analysis showed that CCA-IMT level positively correlated with age, the average of 24 h SBP, FPG and MBPS （P〈0.01） ; Compared with the NMBPS group, the severity of carotid arteries plaque of the MBPS group was significantly higher（P〈0.05）. The MAU of the MBPS group was significantly more than that the NMBPS group（P〈0.05） ; Pearson relation analysis showed that MAU level positively correlated with age, Uric acid, FPG and MBPS（P〈0.05）. CONCLUSION The study showed that MBPS was closely related with carotid atherosclerosis and MAU. It had important significance in concurrent inhibition of morning BP surge in the treatment of high blood pressure.