高血压患者动态血压负荷参数与颈动脉粥样硬化关系的探讨

An investigation on the relationship between carotid artery atherosclerosis and the dynamic blood pressure load in hypertensive patients

目的探讨高血压患者动态血压负荷参数与颈动脉粥样硬化的关系。方法采用B型超声测定颈动脉内膜中层厚度和硬化斑块指数。检测105例患者，高血压伴颈动脉硬化患者95例。分为4组，0期组23例，Ⅰ期组23例，Ⅱ期组28例，Ⅲ期组21例。正常血压（对照组）16例。分别测定24b、白昼、夜间血压负荷及分级血压负荷（分为1—3级）。结果高血压颈动脉硬化0期组的血压负荷与对照组比较有显著差异（P〈0．001）；0期、Ⅰ期组昼夜血压负荷差大，Ⅱ、Ⅲ期组夜间血压负荷明显上升。0期、Ⅰ期组分级血压负荷主要集中在1级血压负荷，Ⅱ、Ⅲ期组中的2、3级血压负荷依次递增，负荷脉压差增大。结论夜间血压负荷的增加致昼夜节律异常，分级血压负荷的升高，负荷压差的增加均对高血压颈动脉硬化的综合评价起重要作用。

Objective To investigate the relationship between carotid artery atherosclerosis and the dynamic blood pressure load in hypertensive, patients. Methods A total of 105 patients were examined by B-mode ultrasonic measurement to evaluate the thickness of intima-media of carotid artery and the atherogenic index. Eighty-nine of them had hypertension accompanied by carotid artery atherosclemsis. They were divided into four groups according to the different atherosclemsis stages. Each of them received an ambulatory blood pressure monitoring. The blood pressure load was categorized into three grades. Results The blood pressure load values of hypertension cases with stage-0 carotid artery artherosclerosis were much higher than those of normal group（ P 〈 0.01）. The difference of blood pressure load between daytime and night was obvious in stages-0 and Ⅰ atherosclerosis. The blood pressure load values during sleeping period of the patients with stages- Ⅱ and Ⅲ atherosclerosis increased explicitly. Conclusions Increase in blood pressure load in night causing abnormal circadian rhythms, rise in grade of blood pressure load, and increase in difference between the SBP and DBP load play important roles in comprehensive evaluation of carotid artery athemsclerosis in hypertension.