高血压患者动态动脉僵硬指数与血压变异性的关系

Association of ambulatory arterial stiffness index with blood pressure variability in hypertensives

目的探讨高血压患者动态动脉僵硬指数(AASI)与血压变异性(BPV)的关系。方法入选2009-03-2011-10中国医科大学附属第一医院就诊的高血压患者119例,所有患者均行24h动态血压监测。AASI定义为1减去24h舒张压和收缩压的回归系数。依据AASI水平,分为4组:AASI<0.30、0.30～<0.41、0.41～<0.52、≥0.52。结果相关性分析显示,AASI分别与年龄(r=0.301,P<0.01)、24h收缩压(r=0.276,P=0.001)、白昼收缩压(r=0.225,P=0.008)、夜间收缩压(r=0.366,P<0.01)、24h脉压(r=0.510,P<0.01)、24h收缩压标准差(r=0.297,P=0.001)呈正相关,而与24h舒张压标准差(r=-0.256,P=0.002)、24h平均心率标准差(r=-0.205,P=0.017)及24h平均动脉压标准差(r=-0.202,P=0.017)呈负相关。多元线性逐步回归分析显示,AASI与24h脉压和24h收缩压标准差呈正相关(β=0.321,β=0.725,均P<0.01),与24h舒张压标准差和24h平均动脉压标准差呈负相关(β=-0.428,β=-0.346,均P<0.01)。结论 AASI与BPV密切相关。

Objective To investigate the relationship between ambulatory arterial stiffness index （AASI） and blood pressure variability （BPV） in patients with hypertension. Methods A total of 119 hypertensives from First Affiliated Hospital of China Medical University between March 2009 and October 2011 were enrolled in this study. All the cases underwent 24-h ambulatory blood pressure monitoring. AASI was defined as one minus the regression slope of 24-h diastolic on systolic blood pressure. The subjects were divided into four groups： AASI〈0.30, 0. 30-0. 41, 0.41-0.51, ≥0.52 according to the levels of AASI. Results Correlation analysis indicated that AASI was positively correlated with age （r= 0. 301, P〈0.01）, 24-hour systolic blood pressure（ 24hSBP, r= 0. 276, P=0. 001） , day systolic blood pressure （dSBP, r=0. 225, P=0. 008） , night systolic blood pressure （nSBP, r= 0. 366, P^0.01）, 24-hour pulse pressure （24hPP, r= 0. 510, P〈0.01）, and 24-hour systolic blood pressure standard deviation （24hSBPSD, r=0. 297, P=0. 001）; but negatively associated with 24-hour diastolic blood pres- sure standard deviation （ 24hDBPSD, r = - 0. 256, P = 0. 002 ）, 24-hour average heart rate standard deviation （24hHRSD, r= - 0. 205, P = 0. 017 ）, and 24-hour mean arterial pressure standard deviation （ 24hMAPSD, r= -0. 202, P=0. 017）. AASI showed positive relevance with 24hPP and 24hSBPSD （β=0. 321, p=0. 725, all P〈0.01） , while reverse correlation with 24hDBPSD and 24hMAPSD （β=-0. 428, β=-0. 346, all P〈0.01） by mul tiple linear stepwise regression analysis. Conclusion AASI is closely related to blood pressure variability.