老年原发性高血压患者血压昼夜节律及颈动脉狭窄对认知功能的影响

Ambulatory blood pressure rhythm,carotid stenosis and cognition function damage in elderly hypertensive patients

目的探讨老年高血压患者24 h动态血压节律及颈动脉狭窄对认知功能损害的影响。方法依据24 h动态血压、颈动脉超声检查联合影像学检查,将190例受试者按24 h动态血压节律类型及颈动脉狭窄程度分组,用简易智能状态检查表(MMSE)对所有受试者进行认知功能调查,MMSE得分范围为0～30分。结果颈动脉狭窄患者非杓型高血压组24 h平均收缩压、平均动脉压等高于杓型组;颈动脉狭窄越重,24 h平均收缩压、平均动脉压等越高;颈动脉不同狭窄度间MMSE得分显著不同,颈动脉狭窄越重,MMSE得分越低,且非杓型组MMSE得分低于杓型组,差异均有统计学意义;非杓型高血压与颈动脉狭窄对认知功能损害有交互作用。结论血压昼夜节律减弱或消失及颈动脉狭窄对老年高血压患者的认知功能损害有协同作用。

Objective To explore the relationship between 24 hours ambulatory blood pressure rhythm, carotid stenosis and cognition function damage in elderly hypertensive patients. Methods 24 hours ambulatory blood pressure monitoring （ABPM） and ca- rotid artery ultrasonic examination were carried out in 190 elderly hypertensive patients. Cognition function was evaluated by Mini - Men- tal State Examination （MMSE）. Results There was significant difference were found between ambulatory blood pressure rhythm and ca- rotid stenosis and MMSE. The interaction between ambulatory blood pressure rhythm and carotid stenosis on MMSE was demonstrated, the carotid stenosis was more severe, and the MMSE was lower. And dipper hypertensive patients had greater MMSE than non -dipper hypertensive. Ambulatory blood pressure rhythm and carotid stenosis was associated with various ingredient of MMSE. Interaction be- tween ambulatory blood pressure rhythm and carotid stenosis was shown in cognition function. Conclusion Cognition function is dam- aged by synergistic effect of abnormal circadian rhythm of ambulatory blood pressure and carotid stenosis in the old hypertensive.