清晨血压高峰与颈动脉粥样硬化的关系研究

The relativity study of carotid atherosclerosis and morning blood pressure surge

目的探讨清晨血压高峰与颈动脉粥样硬化的关系。方法97例轻、中度原发性高血压患者行24h动态血压监测，并根据监测结果将之分为存在清晨血压高峰组（MP＋组，31例）和无清晨血压高峰组（MP-组，66例）。所有患者经彩色多普勒超声检测颈动脉内膜-中层厚度（IMT）和粥样硬化斑块的发生情况，观察清晨血压高峰与颈动脉IMT和动脉粥样硬化斑块发生率的相关性。结果MP＋组患者颈总动脉（CCA）、颈总动脉分义处（CAB）和颈内动脉（ICA）的IMT均高于MP-组[（1．02±0．36）mm比（0．86±0．22）mm、（1．14±0．39）mm比（0．96±0．26）mm和（0．94±0．30）mm比（0．82±0．18）mm，P〈0．05]。MP＋组颈动脉粥样硬化斑块的发生率为64．5％（20／31），MP-组为42．4％（28／66），两组比较差异有统计学意义（P〈0．05）。结论清晨血压高峰与颈动脉粥样硬化相关，清晨血压高峰可加速动脉粥样硬化的形成和发展。

Objective To investigate the relativity between morning blood pressure surge （MBPS） and carotid atherosclerosis. Methods Noninvasive ambulatory blood pressure monitor （ABPM） was performed on 97 patients with the first and second stage of essential hypertension and according the ABPM results, the patients were classified into MP＋ group （ 31 cases ） and MP-group （66 cases ）. In the meantime, the carotid intima-media thickness （IMT） and the carotid atherosclerotic plaque was examined by the color Doppler ultrasound. The relationship among MBPS, carotid atherosclerotic plaque and IMT was analyzed. Results The IMT of common carotid artery （CCA）, carotid artery bifurcation （CAB）and internal carotid artery （ICA） in MP＋ group was significantly higher than that in MP- group [ （ 1.02 ± 0.36）mm vs （0.86 ± 0.22） mm, （ 1.14 ± 0.39 ） mm vs（ 0.96 ± 0.26 ） mm, （0.94 ± 0.30） mm vs （0.82 ± 0.18 mm）, P 〈 0.05 ]. The ratio of carotid atherosclerotic plaque in MP＋ group was significantly higher than that in MP- group （64.5% vs 42.4%,P 〈 0.05）. Conclusions The MBPS is related to carotid atherosclerotic plaque and the carotid IMT. The MBPS may accelerate the forming and developing of atherosclerosis.