老年高血压病患者颈动脉内-中膜厚度的影响因素研究

目的 探讨老年原发性高血压病患者动态脉压、脉搏波传导速度及踝臂指数与颈动脉内-中膜厚度的关系.方法 根据动态血压测量的24h平均脉压(24 h mPP)结果将90例老年高血压病患者分为2组,A组24 h mPP≥60 mm Hg(1 mm Hg =0.133 kPa) (n =45),B组24 h mPP ＜60 mm Hg(n =45).2组患者均采用VP-1000动脉硬化测定仪测量臂踝脉搏波传导速度(baPWV)和踝臂血压指数(ABI),采用HD15100SONO-CT彩色多普勒超声检测仪测量颈动脉内-中膜厚度(IMT).分析24 h mPP、baPWV及ABI与IMT的关系.结果 A组24 h mPP为(65.4±6.6)mm Hg、B组24 h mPP为(51.3±5.0) mm Hg,A组的baP-WV高于B组[(1879±343) mm/s比(1667±32)mm/s]、ABI低于B组[(1.08±0.14)比(1.14±0.09)]、IMT值大于B组[(0.82±0.21)比(0.71±0.16)],差异有统计学意义(P＜0.05).直线相关分析示,24hmPP、baPWV与IMT值呈正相关(r=0.461,P＜0.01；r =0.402,P＜0.01),ABI与IMT值呈负相关(r=-0.267,P ＜0.05).多元逐步回归分析示,24 h mPP、血糖、baPWV是影响IMT的主要因素.结论 老年高血压病患者24 hmPP、baPWV、ABI、血糖与IMT相关,动态血压监测和无创动脉硬化检测可早期预测老年人动脉粥样硬化程度,尽早进行干预治疗,以降低心脑血管事件发生率.

Association between ambulatory pulse pressure, pulse wave veocity, ankle brachial index and carotid intim-media thickness in elderly patients with essential hypertension

Objective To investigate the association between ambulatory pulse pressure(24 h mPP),pulse wave veocity( PWV),ankle brachial index(ABI) and carotid intima-media thickness(IMT) in elderly patients with essential hypertension (EH).Methods Ninety elderly patients with EH were divided into 2 groups according to the 24 h mPP:group A (24 h mPP ≥ 60 mm Hg,n =45 ),greup B ( 24 h mPP ＜ 60 mm Hg,n =45 ).The PWV and ABI were measured by the VP-1000 fully automated analyzer,The IMT was measured by using ultrasonic diagneser (HD1S100SONO-CT).The association between 24 h mPP,baPWV,ABI and IMT was analyzed.Results The 24 h mPP in group A was (65.4 ±6.6)mm Hg and was (51.3 ±5.0) mm Hg in group B.The PWV in group A was significantly higher than that in group B ( P ＜ 0.05 ),The ABI in group A was significantly less than that in group B ( P ＜ 0.05 ),and the IMT in group A was significantly higher than that in group B ( P ＜ 0.05).Linear correlation analysis showed 24 h mPP and baPWV was positively sssociated with IMT (r =0.461,P＜0.01 ; r =0.402,P＜0.01),ABI was negatively associated with IMT (r=-0.267,P＜0.05).Multiple stepwise regression analysis showed 24 h mPP,GLU,baPWV the main factors affecting the IMT.Conclusions In elderly patients with EH,24 h mPP,baPWV,ABI and GLU are related to the development of carotid atheresclerosis and monitoring 24 h mPP,PWV and ABI can predict early atherosclerosis.Early prevention and treatment of atherosclerosis can reduce the incidence of cardiovascular events.