老年高血压患者动态血压负荷和脉搏波传导速度的相关性研究

Correlation between ambulatory blood pressure load and pulse wave velocity in elderly hypertensive patients

目的探讨老年高血压患者24 h动态血压负荷与颈桡动脉脉搏波传导速度(crPWV)的相关性。方法选取60～79岁的老年原发性高血压患者187例,对所有入选对象进行24 h动态血压监测,根据获取的24 h动态血压监测参数分为杓型组90例与非杓型组97例,选择同期体检人群82例为正常对照组。所有受试者行24 h动态血压监测,应用脉搏波速度测定仪测定crPWV,并进行分析。结果杓型组及非杓型组24 h、昼间及夜间收缩压、舒张压负荷均显著高于正常对照组(P<0.01)。非杓型组夜间血压负荷较杓型组升高(P<0.05)。杓型组及非杓型组crPWV均较正常对照组升高(P<0.05)。控制性别、年龄因素后,老年高血压患者24 h收缩压、夜间收缩压负荷、昼间舒张压负荷是crPWV影响的主要因素。结论老年高血压患者动态血压负荷升高,大动脉顺应性降低,其中24 h收缩压、夜间收缩压负荷、昼间舒张压负荷是影响大动脉顺应性的主要危险因素。

Objective To study the correlation between 24 h ambulatory blood pressure load and ca- rotid-radial pulse wave velocity（crPWV）in elderly hypertensive patients. Methods The 24 h am- bulatory blood pressure was monitored in 187 elderly primary hypertensive patients. The patients were divided into dipper group（n：90） and non-dipper group（n=97） according to their 24 h am- bulatory blood pressure and 82 healthy elderly individuals served as a control group. Their 24 h ambulatory blood pressure and crPWV were measured. Results The 24 h,day and nocturnal SBP and DBP load were significantly higher in dipper group and non-dipper group than in control group（P^0.01）. The nocturnal SBP load and the crPWV were significantly higher in non-dipper group than in dipper group（P^0.05）. The 24 h and day SBP load and the nocturnal DBP load were the major influencing factors for crPWV after adjustment of sex and age. Conclusion The 24 h SBP load increases while the compliance of conducting arteries decreases in elderly hypertensive patients. The 24 h and nocturnal SBP load and the day DBP load are the major risk factors for the compliance of conducting arteries.