高血压患者血清25(OH)D_3水平与动态血压相关参数及晨峰血压的相关性研究

Relationship between serum 25(OH)D_3 and ambulatory blood pressure monitoring and morning peak blood pressure in patients with hypertension

目的探讨高血压患者血清25羟维生素D3[25(OH)D_3]水平与动态血压相关参数及晨峰血压的关系。方法选择2016年1月~6月于秦皇岛市骨科医院门诊及住院部收治的原发性高血压患者97例,依据25(OH)D_3水平将患者分为正常组(n=33)和缺乏组(n=64)。采用动态血压仪监测24 h血压,记录24 h平均收缩压(24hSBP)、24 h平均舒张压(24hDBP)、日间平均收缩压(dSBP)、日间平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、夜间血压下降率,并判断患者有无血压晨峰(MBPS);采集患者静脉血检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和25(OH)D_3。结果缺乏组患者24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP、晨峰血压发生率均显著高于正常组(P均<0.05),夜间血压下降率小于正常组(P<0.05);高血压患者血清25(OH)D_3水平与24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP、晨峰血压发生率呈负相关(P均<0.05),与夜间血压下降率呈正相关(P<0.05)。结论高血压患者25(OH)D_3缺乏与血压升高、晨峰血压发生率增加密切相关,25(OH)D_3参与了血压昼夜节律调节,同时为晨峰血压患者的治疗提供了新思路。

Objective To explore the relationship between serum 25（OH）D3 and ambulatory blood pressure monitoring（ABPM） and morning blood pressure surge（MBPS） in patients with hypertension. Methods 97 patients with essential hypertension were recruited in Orthopedics hospital of Qinhuangdao from Jan 2016 to Jun 2016, then they were divided into normal group（n=33） and deficient group（n=64） according to serum 25（OH）D3 level. 24 h blood pressure was detected by ABPM, and the 24 h systolic blood pressure（24 hSBP）, 24 h diastolic blood pressure（24 hDBP）, dSBP, dDBP, nSBP, nDBP, nocturnal blood pressure drop rate recorded and it has been determined whether the patient has MBPS. Venous blood was collected to detect fasting plasma glucose（FBG）, total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterol（LDL-C）, HDL-C and 25（OH）D3. Results The 24 hSBP, 24 hDBP, dSBP, nDBP, dSBP, nDBP and MBPS incidence rate in deficient group were significantly higher than those in normal group, while the nocturnal blood pressure drop rate were lower than those in normal group. The 24 hSBP, 24 hDBP, dSBP, nDBP, dSBP, nDBP and MBPS incidence rate were in negative correlation with serum 25（OH）D3 level, while the nocturnal blood pressure drop rate was in positive correlation with serum 25（OH）D3 level. Conclusion The deficiency of serum 25（OH）D3 level were closely related to the increase of blood pressure and the incidence of morning peak blood pressure. It was proved that 25（OH）D3 participated in the circadian rhythm regulation of blood pressure and provided a new idea for the treatment of morning peak blood pressure.