高血压病患者颈动脉粥样硬化与血压变异的相关性

Association of carotid atherosclerosis and blood pressure variation

目的 探讨高血压病患者颈动脉斑块与血压变异以及与心血管危险因素的关系.方法 对2009年4月至2010年6月在高血压科住院患者临床资料进行回顾性分析,其中408例患者颈动脉B超检查及其他临床资料完善,并且均做动态血压监测.结果 （1）颈动脉斑块检出率为55.3%,男女性别间差异无统计学意义,但随年龄增大阳性率显著增加.（2）颈动脉斑块与高血压病病程、空腹血糖、总胆固醇、低密度脂蛋白胆固醇相关.（3）24 h动态血压与颈动脉斑块：随着收缩压变异系数增大,颈动脉斑块发生率增加（P=0.001）,舒张压变异系数与颈动脉斑块发生率无相关性（P=0.644）,平均收缩压越大,发生率越高（P=0.002）.（4）多元回归提示,颈动脉斑块与24 h平均收缩压、24 h收缩压变异系数相关（P〈0.05）.结论 在高血压病患者中,颈动脉粥样硬化与血压变异系数、尤其是收缩压变异系数独立相关.

Objective To investigate the relationship of carotid artery plaque and blood pressure variation and cardiovascular risk factors.Methods We retrospectively analyzed clinical data of in-patients treated in the department of hypertension between April 2009 and June 2010.Information on carotid ultrasonography and other clinical date were obtained from 408 patients.All patients were monitored by ambulatory blood pressure.Results （1） Carotid artery determined in plaque was 55.3%,there was no differences between men and women.However,the carotid artery plague was associated positively with age.Increased age was associated with a significantly increased positive rate.（2） Cardiovascular risk factors and carotid artery plaque： carotid artery plaque was associated with duration of disease, fasting blood sugar, total cholesterol, and low density lipoprotein-cholesterol.（3） 24 h ambulatory blood pressure and carotid artery plaque： the prevalence of carotid artery plaque increased with increasing coefficient of systolic variation （P=0.001）.There was no correlation between the coefficient of diastolic variation and the prevalence （P=0.644）.（4） Multivariate regression analysis indicated that carotid artery plaque was associated with duration of hypertension, 24 h mean systolic blood pressure, and coefficient of variation of 24 h blood pressure （P〈0.05 ）.Conclusion Carotid atherosclerosis is independently associated with coefficient of variation of blood pressure, especially with coefficient of variation of systolic blood pressure.