高血压伴颈动脉粥样硬化患者的动态血压分析

Analysis of ambulatory blood pressure in essential hypertensive patients with carotid artery atherosclerosis

目的 了解高血压病伴颈动脉粥样硬化 (CAS)患者血压的动态变化。方法 监测CAS组患者、颈动脉内膜增厚 (I组 )患者、颈动脉斑块形成 (Ⅱ组 )患者和颈动脉正常 (CAN)组患者的24h平均收缩压 (24hMSP)、白天平均收缩压 (dMSP)、夜间平均收缩压 (nMSP)、24h平均舒张压 (24hMDP)、白天平均舒张压 (dMDP)、夜间平均舒张压 (nMDP)。 结果 CAS组及Ⅱ组的24hMSP、dMSP、nMSP均高于CAN组 (均P<0.05) ;Ⅰ组nMSP、dMDP、nMDP高于CAN组 (P<0.05) ;CAS组的非杓型血压检出率均明显高于CAN组 (均P<0.01) ,而舒张压的各项测值与CAN组间差别无显著性意义 (均P>0.05)。结论 动态血压的平均收缩压增高及血压昼夜节律异常是造成高血压患者动脉粥样硬化特别是粥样斑块形成的重要原因 ,单纯血压昼夜节律异常即可导致动脉内膜的增厚。

Objective To study the changes of ambulatory blood pressure in essential hypertensive paˉtients with different degree of carotid artery atherosclerosis.Methods The mean values of24h systolic pressure(24hMSP),daytime systolic pressure(dMSP),night time systolic pressure(nMSP),24h diastolic pressure(24hMDP),daytime diastolic pressure(dMDP)and night time diastolic pressure(nMDP)were measured in hypertensive patients with carotid atherosclerosis(CAS),carotid artery intima thicken(CAT),carotid artery atherosclerotic plaque(CAP)and normal carotid artery(CAN).Results24hMSP,dMSP,nMSP of CAS group and CAP group were higher those of CANgroup(P<0.05),while for CATgroup the nMSP、dMDP、nMDP were higher than those of CANgroup(P<0.05).The detectable rate of non-dipper blood pressure in CAS group was significantly higher than that in CAN group(P<0.01).Conclusion The rise of the mean systolic blood presˉsure and the abnormal rhythm of blood pressure may be the cause for the formation of artery atherosclerosis in patients with essential hypertension.