24h动态血压昼夜节律与老年高血压患者认知功能的关系

Relationship Between 24-hour Ambulatory Blood Pressure Circadian Rhythm and Cognition Function in the Elderly Hypertensives

目的探讨24h动态血压昼夜节律与老年高血压患者认知功能的关系。方法入选老年高血压患者292例进行24h动态血压监测,根据夜间血压下降率(ΔMBP)分为杓型(10%～20%,n=101)、非杓型(0%～<10%,n=92)、超杓型(>20%,n=53)和反杓型(<0%,n=46);另入选100例同期健康体检者为正常对照组。用简易智能状态检查表(MMSE)中文版对所有受试者进行认知功能调查,比较各组间MMSE评分的差异。结果高血压组MMSE得分低于正常对照组(24.7±2.1比正常对照组28.9±3.0,P<0.05)。高血压亚组中非杓型、超杓型和反杓型者的MMSE得分均低于杓型者,超杓型和反杓型又低于非杓型者(杓型26.6±2.6比非杓型25.3±2.2比超杓型23.7±1.9比反杓型23.3±2.1,均P<0.05),但超杓型和反杓型之间MMSE的差异没有统计学意义(P>0.05)。结论 24h动态血压昼夜节律减弱或消失与老年高血压患者认知功能的损害有关。

Objective To study the relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in elderly hypertension patients.Methods 24-hour ambulatory blood pressure monitoring （ABPM） was performed in 292 elderly hypertensive patients.Patients were divided into dipper hypertensives （n=101）,non-dipper hypertensives （n=92）,super-dipper hypertensives （n=53） and reverse-dipper hypertensives （n=46）.One hundred healthy subjects served as control.Cognition funtions were evaluated by mini-mental state examination （MMSE）.Results Scores of MMSE in hypertension group were significantly lower than that of control（24.7±2.1 vs cnotrol 28.9±3.0,P0.05）.Scores of MMSE in non-dipper,super-dipper and reverse-dipper hypertensives were significantly lower than that of dipper hypertensives.The scores in super-dipper and reverse-dipper hypertensives were also lower than that of non-dipper hypertensives （non-dipper：25.3±2.2 vs super-dipper：23.7±1.9 vs reverse-dipper：23.3±2.1 vs dipper：26.6±2.6,all P0.05）,but there was no significant difference between super-dipper and reverse-dipper hypertensives （P0.05）.Conclusion Attenuation or disappearance of 24-hour ambulatory blood pressure circadian rhythm damages the cognition function of elderly hypertensive patients.