原发性高血压患者晨峰现象对颈动脉硬化及心、肾的影响

Effect of morning blood pressure surge on carotid artery arteriosclerosis,heart and kidney in patients with essential hypertension

目的探讨原发性高血压晨峰现象(MBPS)对颈动脉硬化及心、肾的影响。方法根据24 h动态血压监测结果,将298例原发性高血压患者分为MBPS组153例和非MBPS组145例,检查患者的心脏和双侧颈动脉彩超情况,对颈动脉内膜中层厚度(IMT)、左室质量指数(LVMI)及斑块的发生率进行计算,并测定尿微量白蛋白。结果 24 h、白昼、夜间平均收缩压及血压晨峰值,MBPS组患者均较非MBPS组患者高;LVMI、左室肥厚(LVH)比例及颈动脉IMT,MBPS组均明显高于非MBPS组;颈动脉斑块的发生率及尿微量白蛋白水平,MBPS组明显高于非MBPS组。结论有MBPS现象的患者对靶器官有明显的损害。

Objective It is to investigate the effect of morning blood pressure surge （MBPS） on carotid artery arterioscle- rosis, heart and kidney in patients with essential hypertension. Methods Two hundred and ninety-eight patients were divided into MBPS group （n = 166） and non-MBPS group（ n = 132） according to the results of 24 h ambulatory blood pressure monito- ring. Left ventricular mass index（LVMI） , carotid intimamedia thickness（IMT） , urinary microglobulin were determined, and the frequency of carotid atherosclerosis and plaque were compared between two groups. Results 24-hours, daytime and night average systolic blood pressure and morning peak of MBPS group were significantly higher than those in non-MBPS group. LV- MI, LVH, carotid IMT in MBPS group was obviously higher that that in non-MBPS group. The frequency rate and the level of urinary micorglobulin were higher in MBPS group than that in non-MBPS group. Conclusion Patients with essential hyperten- sion with MBPS have evident target organ damage.