踝肱指数、血压节律与颈动脉内-中膜厚度关系研究

Study On Ankle Brachial Pressure Index ambulatory blood pressure rhythm And Carotid Intima-medial Thickness

目的探讨踝肱指数(Ankle brachial pressure index,ABI)及动态血压节律(ambulatory blood pressure rhythm,ABPR)与颈动脉内-中膜厚度(carotid intima-medial thickness,IMT)的关系。方法入选的92名2型糖尿病合并高血压患者测量ABI,动态血压监测并计算昼夜血压节律,测量颈动脉IMT,进行详细病史采集,检测生化指标,记录研究对象的年龄、身高、体重等。根据动态血压节律将入选患者分成2组:即杓形组与非杓形组,进行各检测指标参数比较。以颈动脉IMT为因变量,将年龄、ABI、体重指数(BMI)、尿微量白蛋白、血清生化指标、病史为自变量作多元逐步回归分析。分别比较血压节律、ABI单项异常,二者异常及二者正常时颈动脉IMT增厚的检出率。结果杓型血压与非杓型血压组各参数比较,ABI低于杓型组,差异有统计学意义,颈动脉IMT与各影响因素进行多、元逐步回归分析,进入回归方程的因素有ABI;血压节律、ABI单项异常较二项联合检查时颈动脉IMT增厚的阳性率低。结论血压节律的异常可以造成血管壁损伤;联合观察ABI和动态血压节律的变化较单独测量对大血管病变有更好的预见性。

Objective To investigate the relationship between ankle brachial pressure index （ABI）, ambulatory blood pressure rhythm （ABPR） and carotid artery intima-medial thickness （IMT）, to assess the clinical significance of ankle brachial pressure index and ambulatory blood pressure rhythm as well as combination of the two test in patients with type 2 diabetes macroangiopathy. Methods In this study, ABI and ABPR and carotid artery IMT were made in 92 patients with diabetes compile hypertension, as well as to take notes general state of health. The relationships between ABI,ABPR and IMT were examined. Results （1） To compare factors between Abhor- ABPR and nor-ABPR, differences of ABI and IMT were significant. （2） As both ABPR and ABI is abnormal, detection rate of Abhor- IMT （IMT〉0.8） is higher than it that ABI or IMT is abnormal. Conclusions Abnor- ABPR may affect arterial blood vessel, resulting to macroangiopathy and microangiopathy. Measurement of ABI and ABPR might provide a good prognostic indictor.