高血压患者脉搏波流速与血压及血压变异性指标的相关性分析

Correlation among pulse wave velocity, blood pressure and blood pressure variability in patients with hypertension

目的评估高血压患者脉搏波流速(PWV)与血压变异性指标的相关性。方法自2015年1月~2015年7月连续入组京西医院心内科门诊的高血压患者50例,均进行24 h动态血压监测(ABPM)和PWV检查,计算患者的血压变异性指标,包括24 h、日间、夜间收缩压及舒张压的标准差(SD)、变异系数(CV)和血压变异时率(每分钟血压的变化)。结果 50例高血压患者平均年龄(61.16±8.99)岁,男性19例(38.0%),其中糖尿病患者占30.0%,血脂异常患者占72.0%。24 h平均血压为125.25/76.15 mmHg(1 mmHg=0.133k Pa),PWV为7.86 m/s。血压变异性指标分析可知收缩压的标准差、血压变异时率高于舒张压;而舒张压的血压变异系数高于收缩压。Pearson相关性分析结果表明:调整性别、年龄、糖尿病、血脂异常及服用药物情况后,PWV与24 h平均SBP(r=0.326,P=0.045)、24 h平均DBP(r=0.486,P=0.002)、日间平均SBP(r=0.324,P=0.047)、日间平均DBP(r=0.496,P=0.002)和夜间平均DBP(r=0.400,P=0.013)呈明显正相关。而并没有发现PWV与血压变异指标的相关性(P均>0.05)。结论基于本研究结果发现高血压患者PWV与动态血压绝对值相关,而并没有发现其与血压变异性指标的相关性。

Objective To review the correlation among pulse wave velocity (PWV) and indexes of blood pressure variability (BPV) in patients with hypertension. Methods The patients with hypertension (n=50) were chosen from the Department of Cardiology of Jingxi Hospital from Jan. 2015 to Jul. 2015, and all of them were given examinations of 24 h ambulatory blood pressure monitoring (ABPM) and PWV. The indexes of BPV were calculated including standard deviation (SD), coefficient of variation (CV) and time rate of BP variation (BP changes at every min) of 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP), daytime SBP and DBP and nighttime SBP and SBP. Results The average age was (61.16±8.99) in 50 hypertension patients, and there were 19 male patients (38.0%). The percentage of patients with diabetes was 30.0% and percentage of patients with dyslipidemia was 72.0%. The mean BP was 125.25/76.15 mmHg, and PWV was 7.86 m/s in 24 h. The analysis on indexes of BPV showed that SD and time rate of BP variation of SBP were higher than those of DBP, and CV of DBP was higher than that of SBP. The results of Pearson correlation analysis showed that PWV was positively correlated to 24-h mean SBP (r=0.326, P=0.045),24-h mean DBP (r=0.486, P=0.002), daytime mean SBP (r=0.324, P=0.047), daytime mean DBP (r=0.496, P=0.002) and nighttime mean DBP (r=0.400, P=0.013) after regulating sex, age, diabetes, dyslipidemia and medication. The correlation between PWV and indexes of BPV was not observed (all P>0.05). Conclusion PWV is positively correlated to 24-h and daytime mean BP, and it is not correlated to indexes of BP.