动态脉压和C反应蛋白对老年高血压患者颈总动脉的影响

The effect of ambulatory pulse pressure and CRP on the carotid of the elderly hypertensive patients

目的探讨老年男性高血压患者动态脉压对颈总动脉的影响以及与C反应蛋白(CRP)的相关性。方法入选老年男性高血压患者186例,平均年龄79.82±6.04岁,根据动态脉压水平分为高脉压组(脉压≥60mmHg)和低脉压组(脉压<60mmHg),测定颈总动脉内径(CCA)、内膜-中膜厚度(IMT)以及血浆CRP水平。结果高脉压组CCA、IMT及斑块检出率(分别为8.25±0.72mm、1.32±0.15mm和73.53%)高于低脉压组(分别为7.97±0.74mm、1.01±0.19mm和59.52%)(P<0.05)。高脉压组CRP水平(5.72±2.89mg/L)高于低脉压组(3.81±2.56mg/L)(P<0.05)。IMT与动态脉压及CRP呈正相关,相关系数分别为0.442(P<0.05)和0.416(P<0.05)。差异均有统计学意义。结论高脉压促进老年男性高血压患者颈动脉粥样硬化发生,其机制可能与炎性反应有关。

Objective To investigate the effect of ambulatory pulse pressure （PP）on the carotid of the male elderly hypertensive patients and the relationship between C-reaction protein （CRP）, PP and the carotid. Methods 186 male elderly hypertensive patients with a mean age of 79.82years were divided into two groups according to ambulatory PP magnitude（high PP group, PP≥60 mmHg and low PP group, PP〈60 mmHg）. Internal diameter of common carotid artery （CCA）,intima-media thickness （IMT） and carotid plaque incidences were assessed by uhrasonography and the level of plasma CRP was measured. Results CCA, IMT and the incidence of carotid plaque of the high PP group were significant higher than those of the low PP group（8.25±0.72 mm vs7.97±0.74 ram, 1.32±0.15 mm vsl.01±0.19 ram, 73.53% vs 59.52%, respectively ,P〈0.05 ）. The level of CRP was also higher than that of the low PP group（5.72±2.89 mg/L vs 3.81±2.56 mg/L,P〈0.05）. IMT was correlated positively with PP and the level of CRP （r=0.442,0.416,respectively,P〈0.05）. Conclusions Wide PP contributes to the occurrence of carotid atherosclerosis of the male elderly hypertensive patients. The mechanism is probably related to inflammation reaction.