良性前列腺增生与血压昼夜节律的关系研究

Relationship between Benign Prostatic Hyperplasia and Blood Pressure Circadian Rhythm

背景良性前列腺增生(BPH)和高血压是中老年男性的常见病和多发病,二者关系密切,高血压可能加重BPH患者症状。目的观察原发性高血压病合并BPH患者症状评分与血压昼夜节律之间的关系。方法选择2010年1月—2012年6月于北京大学第一医院住院的原发性高血压病合并BPH患者83例,其中非老年患者27例,老年患者56例。采用国际前列腺症状评分(IPSS)评价患者症状程度,并使用无创动态血压检测仪监测患者24 h血压,分别计算日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、24 h平均收缩压、24 h平均舒张压、平均动脉压、平均脉压、脉压指数和夜间血压下降率。结果患者IPSS为(10.31±8.59)分,IPSS与夜间血压下降率呈负相关(r=-0.273,P<0.05),与平均脉压、脉压指数呈正相关(r=0.380、0.483,P<0.01),与平均动脉压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、24 h平均收缩压、24 h平均舒张压均无直线相关关系(r=-0.181、0.091、-0.121、0.122、-0.187、0.117、-0.127,P>0.05)。非老年患者IPSS为(6.03±6.81)分,IPSS与脉压指数呈正相关(r=0.455,P<0.05),与平均脉压、平均动脉压、夜间血压下降率、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、24 h平均收缩压、24 h平均舒张压均无直线相关关系(r=0.355、0.032、-0.076、0.117、-0.206、0.169、-0.128、0.170、-0.101,P>0.05)。老年患者IPSS为(12.36±8.65)分,IPSS与夜间血压下降率呈负相关(r=-0.281,P<0.05),与脉压指数呈正相关(r=0.271,P<0.05),与平均动脉压、平均脉压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、24 h平均收缩压、24 h平均舒张压均无直线相关关系(r=-0.072、0.224、0.003、-0.244、0.202、-0.149、0.082、-0.197,P>0.05)。结论高血压合并BPH患者的症状越严重,IPSS越高,其血压昼夜节律紊乱和动脉硬化程度越严重。

Background Benign prostatic hyperplasia（ BPH） and hypertension,very common in elderly men,are closely associated. Hypertension may aggravate the symptoms of BPH. Objective To investigate the relationship between International Prostate Symptom Score（ IPSS） and blood pressure（ BP） circadian rhythm（ CH） in patients with essential hypertension（ EH） and BPH. Methods From January 2010 to June 2012,in Peking University First Hospital,83 EH patients with BPH,including 27 non- elderly and 56 elderly,were enrolled in this study. Patients＇ degree of symptoms by IPSS were evaluated,24 h BP with non- invaive ambulatory blood pressure detector were monitored,daytime mean systolic blood pressure（ dSBP）,daytime mean diastolic blood pressure（ dDBP）,nighttime mean systolic blood pressure（ nSBP）,nighttime mean diastolic blood pressure（ nDBP）,24 h mean systolic blood pressure（ 24 hSBP）, 24 h mean diastolic blood pressure（ 24 hDBP）,mean arterial pressure（ MAP）,mean pulse pressure（ MPP）,pulse pressure index（ PPI）,descent rate of nighttime blood pressure（ NBP） were calculated. Results The IPSS was（ 10. 31 ± 8. 59） points,negatively correlated with descent rate of NBP（ r =- 0. 273,P〈 0. 05）,positively with MPP and PPI（ r = 0. 380,0. 483,P〈 0. 01）,not correlated linearly with MAP,dSBP,dDBP,nSBP,nDBP,24 hSBP,24 hDBP（ r =- 0. 181,0. 091,- 0. 121,0. 122,- 0. 187,0. 117,- 0. 127,P〉 0. 05）. In non- elderly patients,IPSS was（ 6. 03 ± 6. 81） points,positively correlated with PPI（ r =0. 455,P〈 0. 05）,not correlated linearly with MPP,MAP,descent rate of NBP,dSBP,dDBP,nSBP,nDBP,24 hSBP,24 hDBP（ r = 0. 355,0. 032,- 0. 076,0. 117,- 0. 206,0. 169,- 0. 128,0. 170,- 0. 101,P〈 0. 05）. In elderly patients,IPSS was（ 12. 36 ± 8. 65） points,negatively correlated with descent rate of NBP（ r =- 0. 281,P〈 0. 05）,positively with PPI（ r = 0. 271, P〈 0. 05）, not correlated linearly with MAP, MPP, dSBP, dDBP, nSBP, nDBP,24 hSBP,24 hDBP（ r =- 0. 072,0. 224,0. 003,- 0. 244,0. 202,- 0. 149,0. 082,- 0. 197,P〉 0. 05）. Conclusion AS the BPH symptom is get serious,the IPSS get higher,BP CH disorders and extent of atherosclerosis get more serious.