血压正常老年性痴呆患者的昼夜血压节律变化

A case-control study of circadian rhythm of blood pressure in patients with normal blood pressure and senile dementia

目的观察老年性痴呆患者的昼夜血压节律变化。方法采用病例对照方法选取2015年1月至2017年4月在杭州市第三人民医院老年科和杭州市红会医院综合内科住院的血压正常老年性痴呆患者49例(男性30例,女性19例)和健康老年人45名(男性28名,女性17名)。观察两组的静息收缩压、舒张压,24 h平均收缩压、平均舒张压,日间平均收缩压、平均舒张压和夜间平均收缩压、平均舒张压。结果病例组中35例(71. 4%)血压呈非杓型,14例(28. 6%)呈杓型,对照组中9例(20. 0%)呈非杓型,36例(80. 0%)呈杓型,两组比较差异有统计学意义(χ~2=24. 92,P <0. 01)。与对照组相比,病例组患者24 h平均收缩压、夜间平均收缩压显著升高(t=2. 639,P <0. 01;t=2. 728,P <0. 01),而两组24 h平均舒张压、日间平均收缩压、舒张压和夜间平均舒张压比较,差异无统计学意义(均为P> 0. 05)。结论血压正常老年性痴呆患者的昼夜血压节律与健康老年人不同,可能与夜间收缩压升高相关。

Objective To observe the changes in circadian rhythm of blood pressure in senile dementia patients with normal blood pressure. Methods A case-control method was used to select 49 cases of normotensive senile dementia（male：30 cases,female：19 cases）and 45 healthy elderly（male：28 cases,female：17 cases）in the Geriatric Department of the Third People s Hospital of Hangzhou and the General Internal Medicine of the Red Society Hospital of Hangzhou from January 2015 to April 2017.Resting systolic blood pressure,diastolic blood pressure;24-hour mean systolic blood pressure,mean diastolic blood pressure;daytime mean systolic blood pressure,mean diastolic blood pressure;nocturnal mean systolic blood pressure and mean diastolic blood pressure were compared between the two groups. Results In the case group,35 cases（71.4%）blood pressure were non dipper type,14 cases（28.6%）were dipper type,in the control group 9 cases（20.0%）were non dipper type,36 cases（80.0%）were dipper type,and the difference between two groups were statistically significant（ χ^ 2=24.92, P 〈0.01）.Compared with the control group,the average systolic pressure of 24 h and the mean systolic pressure at night increased significantly（ t =2.639, P 〈 0.01; t =2.728, P 〈0.01）,while the average diastolic pressure of 24 h,the average daytime systolic pressure,the diastolic pressure and the mean night diastolic pressure were similar in the two groups（all P 〉0.05）. Conclusions Circadian blood pressure rhythm in normotensive elderly patients with senile dementia is different from that in healthy elderly,which may be related to the increase of nighttime systolic blood pressure.