血压晨峰与血糖、血脂的关系初步探讨

Preliminary Exploration for the Relationship of Morning Blood Pressure Surge With Fasting Blood Glucose and Blood Lipids

目的：探讨血压晨峰的危险因素，为采取针对性的预防或治疗措施提供依据。方法：研究对象于2011-01至2011-06在阜外心血管病医院进行24小时动态血压监测，并进行生化指标的检测，研究对象均未服用降压药物，共人选280例，其中男性161例，女性119例，年龄19—79岁。根据所有研究对象收缩压血压晨峰的75％百分位数将其分为两组，即收缩压血压晨峰≥28．4mmHg（1mmHg=0．133kPa）为晨峰组（69例），〈28．4mmHg为非晨峰组（211例）。通过对两组研究对象进行分析，探讨血压水平、血糖水平、血脂水平等与血压晨峰的关系。结果：与非晨峰组相比，晨峰组的空腹血糖水平、高血压患者比例高于非晨峰组，两组比较差异有统计学意义（P=0．005或P=0．002）。24小时动态血压监测结果显示，晨峰组昼间收缩压和平均动脉压显著高于非晨峰组，两组比较差异有统计学意义（P〈0．05），但晨峰组夜间收缩压、舒张压和平均动脉压显著低于非晨峰组，两组比较差异有统计学意义（19〈0．05）。对年龄、性别、体质指数进行调整后，高血压组、空腹血糖受损组和总胆固醇升高组发生血压晨峰的风险分别增加1．596倍（OR=2．596；95％CI：1．392—4．841）、1．381倍（OR=2．381；95％CI：1．304—4．347）和0．904倍（OR=1．904；95％CI：0．866—4．190）。

Objective： To explore the risk factor for morning blood pressure surge （MBPS） and to provide the relevant principle for prevention and treatment in such patients. Methods： We enrolled 280 patients who received 24-hour ambulatory blood pressure monitoring （ABPM） in our hospital from January to June 2011. The patient included 161 male, 119 female with the age of （19-79） years, no one had antihypertensive medication. According to 75% of the average MBPS value, the patients were divided into 2 groups as MBPS group, the patients with MBPS I〉 28.4 mmHg, n=69 and non-MBPS group, the patients with MBPS 〈 28.4 mmHg, n=211. We studied the relationship between MBPS and hypertension, fasting blood glucose （FBG） and blood lipids. Results： Compared with non-MBPS group, the MBPS group had higher FBG level and more hypertension patients, P=0.005 or P=0.002. The 24-hour ABPM presented that day-time systolic blood pressure （SBP） and the mean arterial pressure （MAP） were higher in MBPS group, P〈0.05, while night-time SBP, diastolic blood pressure （DBP） and MAP were lower in MBPS group, P〈0.05. With adjusted age, gender and BMI, the patients with hypertension, impaired FBG and high blood lipids had 1.596 times （OR=2.596; 95%CI： 1.392-4.841）, 1.381 times （OR=2.381; 95%CI： 1.304-4.347） and 0.904 times （OR=1.904; 95%CI： 0.866-4.190） of increased risk for suffering from MBPS, respectively. Conclusion： The patients with hypertension and impaired FBG had the higher risk for exaggerated MBPS.