高脂血症患者血压变异性与动脉血管弹性的关系

Blood pressure variability and arterial elasticity in hyperlipidemic patients

目的:通过对高脂血症总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)比率>5.0患者与健康人群比较,探讨高脂血症的血压变异性(BPV)和动脉顺应性的关系。方法:高脂血症患者33例和血脂代谢正常的健康体检者33例,记录24 h动态血压监测(ABPM)和测量动脉顺应性,两组间经年龄、性别、体质量配对后比较。结果:高脂血症患者组24 h收缩期BPV[(20±6)mmHgvs(16±4)mmHg,P<0.01,1 mmHg=0.133 kPa]、舒张期BPV[(17±5)mmHgvs(14±5)mmHg,P<0.05]和平均动脉压的BPV[(16±5)mmHgvs(13±5)mmHg,P<0.05]明显高于血脂代谢正常的健康体检者。两组间大、小动脉顺应性无显著性差异;健康对照者24 h收缩期BPV与大动脉顺应性呈显著负相关(r=-0.46,P<0.05)。而两组受试者24 h、白天及夜间的BPV与小动脉的顺应性无相关性。结论:高脂血症患者BPV比血脂代谢正常的健康体检者高,但高脂血症患者大动脉顺应性与收缩压无相关性。

AIM： To study the relationship between blood pressure variability （BPV） and arterial compliance in hyperlipidemic subjects, which was defined as total cholesterol （TC）/high-density lipoprotein cholesterol （HDL-C） of 〉 5.0 as compared to normolipidemic subjects. METHODS： Thirty-three hyperlipidemic patients were age- gender- and weight-matched with normolipidemic controls. Twenty-four-hour ambulatory blood pressure monitoring was recorded and arterial compliance was measured. RESULTS： There were significantly higher 24-h systolic [ （20±6） mmHg vs. （16±4） mmHg, P 〈0.01, 1 mmHg =0. 133 kPa], diastolic [（16±5） mmHg vs. （13±5） mmHg, P 〈0.05] and mean arterial [（16±5） mmHg vs. （ 13±5 ） mmHg, P 〈 0.05 ] BPVs in the hyperlipidemic group as compared to those in the normolipidcmic group. There were no significant differences in large and small arterial compliance among groups. In normolipidemic subjects, there was a significant inverse relationship between 24-h systolic BPV and large arterial compliance （ r = 0.46, P 〈 0.05 ）. No significant correlations were found between small arterial compliance and the 24-h BPV, daytime BPV and night-time BPV analyses in subjects of both groups. CONCLUSION： BPV is higher in hyperlipidemic patients as compared to normolipidemic subjects. Large arterial compliance is negatively correlated with SBP in hyperlipidemic patients.