代谢综合征的高血压患者收缩压变异性及血压晨峰的研究

Systolic blood pressure variability and morning blood pressure surge in metabolic syndrome patients with high blood pressure

目的探讨代谢综合征的高血压患者收缩压变异性、血压晨峰的临床特征,并分析其与代谢综合征的心血管危险因素之间的相关性。方法收集门诊高血压患者68例,分成合并有代谢综合征组(A组,n=33)和单纯高血压组(B组,n=35),对两组患者进行24 h动态血压监测(ABPM),连续记录24 h、白天及夜间每半个小时收缩压数值,通过SPSS软件计算24 h、白天及夜间每半小时收缩压均值的标准差,即为24 h收缩压变异性(24 h SBPV),白天收缩压变异性(白天SBPV),夜间收缩压变异性(夜间SBPV);计算起床后2 h内收缩压平均值与夜间睡眠时的收缩压最低值(包括最低值在内的1 h的平均值)的差值即为血压晨峰值。结果通过对A、B两组收缩压变异性、血压晨峰值进行对比分析,了解合并代谢综合征的高血压患者收缩压变异性、血压晨峰值与单纯高血压患者的区别。同时将代谢综合征定义中包括的多个心血管危险因素与24 h SBPV,白天SBPV,夜间SBPV及血压晨峰值进行相关性分析,探讨与收缩压变异性、血压晨峰相关的影响因素。结论合并有代谢综合征的高血压患者血压变异性增加。

Objective To explore systolic blood pressure variability and the clinical characteristics of morning blood pressure surge in metabolic syndrome patients with high blood pressure,clinical features ,and to analyze the relationship between cardiovascular risk fac-tors and metabolic syndrome.Methods We collected 68 cases of hypertension treated in The Second Affiliated Hospital of Anhui Med-ical University from December 2013 to December 2015,which were assigned into two groups,metabolic syndrome combination group （group A,n =33）and simple hypertension group （group B,n =35）.The two groups of patients received 24 hour ambulatory blood pressure monitoring （ABPM）and systolic blood pressure values were recorded continuously every half hour during 24 hours.We then calculated with the SPSS software the standard deviation of systolic blood pressure values during 24 hours,namely,24 hour systolic blood pressure variability （24 h SBPV）,daytime systolic blood ressure variability （day SBPV）and nighttime systolic blood pressure variability （night SBPV）.We also calculated morning blood pressure surge,that is,the difference between the average systolic blood pressure within the 2 hours after getting up and the lowest value of systolic blood pressure at night.Results By comparing and analy-sing systolic blood pressure variabilities and the morning blood pressure surge,we understood the differences in systolic blood pressure variability,the morning blood pressure surge between the two groups.The correlation analysis conducted between multiple cardiovascular risk factors with the 24 h SBPV,the daytime SBPV,the night SBPV,and the morning blood pressure surge showedthe risk factors of sys-tolic blood pressure variability and morning blood pressure surge.Conclusions Metabolic syndrome patients with high blood pressure have increased blood pressure variability.