老年高血压患者的动态脉压与冠心病并发症及颈动脉粥样硬化的关系研究

Research on Relationship of Elderly Hypertensive Patients with Ambulatory Pulse Pressure(PP) and Coronary Heart Disease Complications and Carotid Atherosclerosis

目的:探讨老年高血压患者的动态脉压(PP)与冠心病并发症及颈动脉粥样硬化的关系。方法:选取2010年5月至2013年6月在我院就诊的老年性高血压病患者328例,168例单纯性老年高血压患者设为高血压组,160例合并有冠心病的老年性高血压患者设为高血压合并冠心病组。根据厚度(IMT)是否增大将高血压组分为IMT增厚组94例和IMT正常组74例。对动态血压及颈动脉IMT进行测定。结果:与高血压组相比,高血压合并冠心病组的24 hAPP、dPP、nPP等指标以及24 hASBP、nSBP等指标均显著提高;而24hADBP、dDBP、nDBP等指标则明显下降;高血压合并冠心病组24hA PP艹60 mm Hg的发生率为57.50%,明显高于高血压组的39.29%;IMT增厚组患者的24hA PP、dPP及nPP水平均明显高于IMT正常组;艹60 mmHg组共89例,IMT为1.14±0.23 mm,明显高于<60 mmHg组79例的平均厚度0.93±0.12 mm(P<0.05)。结论:老年高血压患者的动态脉压在冠心病并发症及颈动脉粥样硬化预测方面具有显著的优越性。

Objective： To investigate the relationship of elderly hypertensive patients with ambulatory pulse pressure （PP） and coronary heart disease complications and carotid atherosclerosis. Methods： 328 cases of elderly hypertensive patients in our hospital from May 2010 to June 2013 were chosen as the research objects, the mere 168 cases of elderly patients with hypertension were set as the hypertension group,and 160 cases of CHD were set as hypertension combining coronary heart disease group. The hypertension group were divided into IMT thickening group of 94 cases and 74 cases of IMT normal group. Ambulatory blood pressure and carotid artery 1MT were measured. Results： Compared with the hypertension group, the 24 hAPP, dPP, nPP and 24hASBP, nSBP of Hypertension combining coronary heart disease group were significantly improved, while the 24 hADBP, dDBP, nDBP were obviously decreased;The incidence of 24 hA PP〉 60 nun Hg in hypertension combining coronary heart disease group was 57.50%, significantly higher than that 39.29% in hypertension group; the 24hAPP, dPP and nPP levels oflMT thickening group were significantly higher than the 1MT normal group; there were 89 cases of patients in_〉 60 mmHg group, the 1MT was 1.14＋ 0.23mm,significantly higher than that 79 cases of patients and 0.93 ± 0.12 mm in〈60 mmHg group （P〈0.05）. Conclusion： Dynamic pulse pressure in elderly hypertensive patients has obvious superiority in the prediction of coronary heart disease complications and carotid atherosclerosis.