不同夜间隐匿性高血压亚型与靶器官损害的相关研究

目的 研究不同夜间隐匿性高血压亚型对老年人靶器官损害的差异。方法选取396例住院治疗的老年患者，年龄≥60岁。根据患者夜间血压分为Ⅰ亚型组（夜间正常血压136例），Ⅱ亚型组（夜间舒张期隐匿性高血压130例），Ⅲ亚型组（夜间收缩期隐匿性高血压130例）。根据3组心脏、颈动脉超声、头颅MRI或头颅CT、肾功能等检查，对3组靶器官损害进行分析。结果Ⅲ亚型组的左室重量指数、室间隔厚度、颈动脉内中膜厚度高于Ⅰ亚型组和Ⅱ亚型组（P<0.05），Ⅲ亚型组脑卒中、肾功能的发生率高于I亚型组和Ⅱ亚型组，但3组间差异无统计学意义(P>0.05)。Logistic回归分析显示，夜间收缩期高血压对心血管靶器官的的损害高于舒张期高血压（P<0.05，OR＞1）。结论夜间收缩期隐匿性高血压对心血管靶器官损害高于夜间舒张期隐匿性高血压，夜间收缩期血压升高是发生靶器官损害的危险因素，临床中降低夜间收缩压可能是潜在治疗靶点。

Correlations between different subtype occult nighttime hypertension and target organ damage

Objective To investigate the differences in the damage of target organs in the elderlies by different subtypes of occult nighttime hypertension. Methods Totally 187 elderly patients hospitalized in our department from December 2018 to January 2020, aged≥60 years, were divided into Group Ⅰ(136 patients with normal blood pressure) and Group Ⅱ(130 cases of occult nocturnal diastole hypertension), Group Ⅲ(130 cases of occult nocturnal systolic hypertension). According to heart and carotid ultrasound, brain MRI or brain CT, renal function tests, the target organ damage were carried out for analysis. ResultsThe left ventricular weight index, interventricular septum thickness, and carotid intima-media thickness of Group Ⅲwere significantly higher than those of Group Ⅰand Ⅱ(P<0.05). The occurrence of stroke and renal function impairment in Group Ⅲwere higher than the Group Ⅰand Ⅱ, but the difference among the three groups was not statistically significant. Logistic regression analysis showed that the damage of nocturnal systolic hypertension to cardiovascular target organs was higher than that of diastolic hypertension (P<0.05, OR>1). Conclusion In the occult nocturnal systolic hypertension group, the damage to cardiovascular target organs is higher than that in the occult nocturnal diastole hypertension. Elevated nocturnal systolic blood pressure is a risk factor for target organ damage