血压正常高值者动态血压变化与动脉顺应性的相关性研究

Relation between dynamic blood pressure change and arterial compliance in subjects with normal blood pressure

目的探讨血压正常高值者24 h动态血压变化与颈桡动脉脉搏波传导速度(crPWV)、颈动脉内膜中层厚度(IMT)的相关性。方法入选受试对象286例,其中理想血压组(血压<120/80 mm Hg,1 mm Hg=0.1 33 kPa)90例,血压正常高值组196例,对所有入选对象进行24 h动态血压监测,根据监测参数将血压正常高值组又分为杓型组103例,非杓型组93例,同时进行crPWV及颈动脉IMT检测。结果非杓型组24h收缩压均值较杓型组升高[(122.00)±9.74)mm Hg vs(11 6.74±8.66)mm Hg,P<0.05]。非杓型组夜间血压各指标均较杓型组明显升高(P<0.01),非杓型组crPWV较杓型组升高[(9.53±1.14)m/s vs(8.38±0.88)m/s.P<0.05],非杓型组IMT较杓型组升高[(0.93±0.11)mm vs(0.81±0.1 2)mm,P<0.05],多元回归分析显示,夜间收缩压均值、夜间收缩压下降率、夜间舒张压均值等是crPWV的影响因素,夜间舒张压下降率、24 h收缩压均值、甘油三酯是IMT的影响因素。结论血压昼夜节律异常与crPWV及IMT密切相关,血压正常高值者已出现血管结构与弹性功能异常。

Objeetive To study the rrelation of 24 h ABPM rhythm with crPWV and IMT in subjects with normal blood pressure. Methods Two hundred and eighty-six subjects enrolled in this study were divided into ideal blood pressure（〈20/80 mm Hg）group（n=90） and prehypertension group（n=196）. Their 24 h ABPM,erPWV and IMT were mornitored. The 196 subjects in prehypertension group were further divided into dipper group（n= 103） and non dipper group（n= 93） according to their prehypertension parameters and their crPWV and IMT were measured. Resuits The 24 h systolic blood pressure,crPWV and IMT were higher in non dipper group than in dipper group（122.00±9.74 mm Hg vs 116.74±8.66 mm Hg,9.53±1. 14 m/s vs 8.38±0.88 m/s,0.93±0.11 mm vs 0. 81±0.12 ram,P〈0.05）. Multiple regression analysis showed that the average nocturnal systolic pressure, nocturnal systolic pressure decreasing rate, and average nocturnal diastolic pressure were the factors influencing erPWV,while the nocturnal diastolic pressure decreasing rate, average 24 h systolic pressure, and TG were the factors influencing IMT. Conclusion The abnormal 24 h ABPM rhythm is closely related with crPWV and IMT in patients with abnormal blood pressure. Abnormal vascular structure and elastics can he observed in patients with normal blood pressure.