不同短时收缩压变异性指标与老年人群颈动脉内膜中层厚度的关联

THE CORRELATION STUDY OF SHORT-TERM SYSTOLIC BLOOD PRESSURE VARIABILITY WITH CAROTID INTIMA-MEDIA THICKNESS IN ELDERLY

目的探讨不同短时收缩压变异性指标与老年人群颈动脉内膜中层厚度的关联。方法在参加开滦研究队列第三次健康体检的人群中,采取整群抽样的方法随机抽取年龄≥60岁的开滦集团离退休员工进行24h动态血压监测等检查。在随机抽取的3 064例研究对象中,符合入选标准的为2 464例,最终纳入统计分析的有1 518例。收缩压变异性(Systolic Blood Pressure Variability,SBPV)采用标准差(SD)、独立变异性(VIM)、极差(MMD)和平均真实变异性(ARV)四种指标。采用逐步线性回归方法,分析不同短时SBPV指标与颈动脉内膜中层厚度(CIMT)的关联。结果 (1)在1 518例研究对象中,年龄平均为(67.14±5.94)岁。其中,男性1 000例(65.9%),女性518例(34.1%)。(2)除短时VIM以外,平均收缩压(SBP)越高,短时SBPV均呈升高趋势(P值<0.05)。(3)在逐步线性回归分析中,不同24h、日间SBPV指标均与CIMT呈正线性相关,不同夜间SBPV指标均与CIMT无线性相关。结论不同24h、日间收缩压变异性指标与CIMT均存在一定程度的关联。

Objective To investigate the correlation of short- term systolic blood pressure variability （SB- PV} with carotid intima- media thickness in elderly. Methods A cluster sampling randomly was per- formed in age of 60 or more retired employees in kailuan group in the third time of physical examination, and all subjects underwent 24 - hour ambulatory blood pressure monitoring and carotid artery ultrasonogra- phy. Finally, 1518 participants with integral data were recruited into the survey. SBPV indices were showed by standard deviation of systolic blood pressure （SD）, variability independent of the mean （VIM）, maximum- minimum difference （MMD）, and average real variability （ARV）. Multivariate regression models were used to analyze the influence of short - term SBPV on carotid intima- media thickness. Results Among 1518 participants（67. 14 ± 5. 94） years, 1000 individuals were male and 518 were female. In short- term recordings, SD, MMD and ARV but not VIM was increased with SBP. CIMT increased with all 4 indices of 24 - hour and day- time SBPV but not night- time SBPV. Conclusion All 4 indices of 24 - hour and day- time SBPV have associate with carotid intima- media thickness. K