不同时间点高血压患者左腕脉搏波传导时间的动态变化及影响因素

Changes in left wrist pulse wave transit time in patients with hypertension and influencing factors

目的探讨不同时间点高血压患者左腕脉搏波传导时间的动态变化、血清学指标及不良生活方式的影响。方法收集2020年6月至2021年4月于解放军总医院海南医院收治的高血压患者321例,根据简单随机分组法分为两组,对照组135例患者在晨起后饮水20 mL,观察组186例在对照组基础上加服硝苯地平控释片(拜新同,30 mg,QD),采用智能腕表收集两组患者服药(饮水)后0.5 h、4.5 h、8.5 h的左腕脉搏波传导时间进行重复测量的方差分析,观察时间、交互效应、服药对脉搏波传导时间的影响;收集患者性别、年龄、身高、体质量、左臂围、左臂长、静息心率、吸烟、限量饮酒等资料,采集空腹血4 mL检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、尿酸(UA)等指标,分析脉搏波传导时间的可能影响因素。结果时间效应具有统计学意义(F=12.065,P<0.001),交互效应无统计学意义(F=0.089,P=0.915),组间效应无统计学意义(F=2.074,P=0.155),FBG、TC、TG、静息心率、限量饮酒等有统计学差异(P<0.05)。结论高血压患者日间左腕脉搏波传导时间随着时间的延长而逐渐缩短,与是否服用降压药无明显联系,可能与FBG、TC、TG、静息心率、限量饮酒等指标有关。

Objective To investigate the changes in left wrist pulse wave transit time(PTT)in patients with hypertension,as well as the effects of serological indicators and unhealthy lifestyle.Methods We recruited 321hypertensive patients admitted to Chinese PLA General Hospital Hainan Branch from June 2020 to April 2021 and divided them into two groups according to the simple randomization method.Totally 135 patients in the control group drank 20 mL of water after getting up in the morning and 186 patients in the observation group took the nifedipine controlled release tablets on the basis of the control group.A smart watch was used to collect the PTT at 0.5 h,4.5 h,and 8.5 h after taking the medicine(drinking water)for the two groups.Repeated measurement analysis of variance was used to observe the influences of the time,interaction effect,and medicine on PTT.The data of gender,age,height,weight,left arm circumference,left arm length,resting heart rate,smoking,and alcohol drinking were collected.Fasting blood of 4 mL was collected to detect indicators such as fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),and uric acid(UA)to analyze possible factors affecting PTT.Results The time effect was statistically significant(F=12.065,P<0.001),while the interaction effect was not(F=0.089,P=0.915).There was no statistically significant difference between the two groups(F=2.074,P=0.155).FBG,TC,TG,resting heart rate,and limited alcohol drinking differed significantly(P<0.05).Conclusion PTT gradually shortens with time,and it has no significant relationship with antihypertensive drugs,but may be related to FBG,TC,TG,resting heart rate,alcohol drinking and other indicators.