高龄老年人血压变异性与踝臂指数关系探讨

目的评价高龄老年人群血压变异性(BPV)与踝臂指数(ABI)的关系。方法入选年龄≥80岁高龄老人111例,按照ABI分为异常ABI组(ABI≤0.9或ABI>1.3)56例和正常ABI组(ABI>0.9)55例,比较2组24h动态血压参数和BPV参数;另根据血压将患者分为高血压组48例和非高血压组63例,观察2组BPV及ABI差异。logistic回归分析ABI独立危险因素。结果异常ABI组较正常ABI组24h舒张压、昼间舒张压和夜间舒张压明显降低(P<0.05),24h收缩压变异性(12.80±2.66)mm Hg(1mm Hg=0.133kPa)vs(14.14±3.64)mm Hg]明显降低、夜间收缩压变异性(11.99±4.19)mm Hg vs(9.97±4.05)mm Hg]明显增高(P<0.05)。高血压组24h收缩压变异性(14.87±3.91)mm Hg vs(13.20±3.41)mm Hg]、夜间收缩压变异性(12.27±5.50)mm Hg vs(10.33±3.93)mm Hg]明显增高,ABI(0.98±0.21)vs(1.07±0.20)]明显降低(P<0.05)。logistic回归分析提示,夜间舒张压和夜间收缩压变异性为ABI的独立危险因素(P<0.05)。结论高龄老年人群24h舒张压、昼间及夜间舒张压、24h收缩压变异性、夜间收缩压变异性可能是异常ABI的危险因素。

Relationship between blood pressure variability and ankle-brachial index in people with their over age 80 years

Objective To investigate the relationship between blood pressure variability(BPV)and ankle-brachial index(ABI)in people with their age≥80years.Methods One hundred and eleven people with their age≥80years were divided into ABI≤0.9group(n=56)and ABI>0.9group(n=55)according to their ABI.Their 24 hambulatory blood pressure(24hABP)and BPV were compared and analyzed.The patients were further divided into hypertension group(n=48)and non-hypertension group(n=63)according to their blood pressure.Their BPV and ABI were recorded.The independent risk factors for ABI were analyzed by logistic regression analysis.Results The 24 hDBP,dDBP,nDBP and 24 hSBP,dSBP,nSBP were significantly lower in ABI≤0.9group than in ABI>0.9group(P<0.05).The 24 hSBPV was lower while the nSBPV was higher in ABI≤0.9group than in ABI>0.9group(12.80±2.66 mm Hg vs 14.14±3.64 mm Hg,11.99±4.19 mm Hg vs 9.97±4.05 mm Hg,P<0.05).The 24 hSBPV and nSBPV were higher while the ABI was lower in hypertension group than in non-hypertension group(14.87±3.91 mm Hg vs 13.20±3.41 mm Hg,12.27±5.50 mm Hg vs 10.33±3.93 mm Hg,0.98±0.21 vs1.07±0.20,P<0.05).Logistic regression analysis showed that the nDBPV and nSBPV differed greatly(P<0.05).Conclusion The 24 hDBP,dDBP,nDBP,24 hSBPV and nSBPV are the risk factors for ABI in people with their age≥80years.