动态血压参数与颈动脉粥样斑块的关系研究

Relationship between ambulatory blood pressure parameters and carotid atherosclerotic plaque

目的:分析动态血压参数与颈动脉粥样斑块的关系,探讨有效降低动脉粥样硬化发生的途径。方法:抽取2015年1至2015年12月在厦门大学附属第一医院住院患者254例为研究对象,根据颈动脉超声检查结果分为两组,即颈动脉斑块组144例和颈动脉无斑块组110例。收集其一般资料、颈动脉超声及动态血压检查参数,相关因素行Pearson分析。结果:颈动脉斑块形成与年龄、白天收缩压均值、夜间收缩压均值、白天收缩压负荷值、夜间收缩压负荷值呈正相关,与收缩压下降率、舒张压下降率呈负相关(P<0.05)。控制年龄、性别、体质指数等因素后,白天收缩压均值、夜间收缩压均值、白天收缩压负荷值、夜间收缩压负荷值仍与颈动脉斑块呈正相关(r=0.145、0.170、0.151、0.167,P=0.049、0.023、0.044、0.025)。结论:相较血压变异性,颈动脉斑块的发生与血压平均值密切相关。更多地关注血压水平,控制血压平均值和负荷值,可能是减少颈动脉斑块发生的重要途径。

Objective To analyze the relationship between ambulatory blood pressure parameters and carotid atherosclerotic plaques,and investigate effective ways to reduce the incidence of atherosclerosis.Methods A total of 254 inpatients in the First Affiliated Hospital of Xiamen University from January 2015 to December 2015 were selected as the objects of the study,and they were divided into two groups according to the results of carotid ultrasound examination,namely 144 cases in the carotid plaque group and 110 cases in the carotid plaque-free group.Basic data,carotid ultrasound and ambulatory blood pressure parameters were collected,related factors were analyzed by Pearson.Results Carotid plaque formation was positively correlated with age,mean daytime systolic blood pressure,mean nighttime systolic blood pressure,datime systolic blood pressure load and nighttime systolic blood pressure load,and negatively correlated with systolic blood pressure drop rate and diastolic blood pressure drop rate(P<0.05).After age,gender,body mass index and other factors were controlled,the mean daytimesystolic blood pressure,the mean nighttimesystolic blood pressure,the daytime systolic blood pressure load and the nighttime systolic blood pressure load still had positive correlation with carotid artery plaque(r=0.145,0.170,0.151,0.167,P=0.049,0.023,0.044,0.025).Conclusions Compared with blood pressure variability,the occurrence of carotid plaque is closely related to the mean blood pressure.More attention to blood pressure level,controlling mean blood pressure and load value may be an important way to reduce the incidence of carotid plaque.