高血压病患者脉压与靶器官损害的关系

The Relationship Between Pulse Pressure and Target Organs Damage in Essential Hypertensive Patients

目的 探讨脉压与高血压病靶器官损害的关系。方法 回顾性调查近 5年住我院未治疗高血压病患者 696例(男 3 87例 ,女 3 0 9例 ) ,按平均压 <10 7mmHg和≥ 10 7mmHg分为二组 ,再分别以脉压≤ 60mmHg ,60 <PP≤ 80mmHg ,80 <PP≤ 10 0mmHg ,>10 0mmHg分为 4个亚组。分析各亚组的脉压与体重指数 (BMI)、血糖、血脂、BUN、Cr、UA、CCr、LVMI、EF、FS及心脑并发症发生率的相关性。结果 ( 1)各亚组的高血压病史、吸烟者、饮酒者、BMI、血糖、甘油三酯 (TG)、胆固醇 (TC)、高密度脂蛋白 (HDL)及低密度脂蛋白 (LDL)无明显差别 (P >0 0 5) ;( 2 )脉压与BUN、Cr、UA、年龄、SBP、LVMI呈正相关 (r分别为 0 75,0 60 ,0 70 ,0 48,0 59,0 56,P均 <0 0 5) ,而与CCr、DBP、FS、EF呈负相关 (r分别为 -0 68,-0 52 ,-0 49,-0 51,P均 <0 0 5)。 ( 3 )左室肥厚、冠心病、心功能不全及脑并发症的发生率与患者年龄、收缩压、舒张压和脉压有关 (P均 <0 0 5) ,统计学分析脉压起着更重要的作用。结论 高血压病患者的靶器官损害与年龄、收缩压、舒张压和脉压等因素有关 。

Objective To investigate the relationship between pulse pressure (PP)and target organs damage in essential hypertensive patients. Methods Six hundred ninety six cases of untreated primary hypertensive patients (387 male and 309 female) were divided into two groups according to the level of mean arterial pressure (<107 and ≥107 mmHg). Each group was further divided into four subgroups according to the level of pulse pressure (≤60, 60<PP≤80, 80<PP≤100, and >100 mmHg). The relationship between PP and BMI, serum level of glucose, lipids, BUN, Cr, UA, CCr, LVMI, EF, FS and the incidence of cardiovascular events were analyzed among these subgroups. Results (1) The course of hypertension,the rate of smokers, the rate of drinkers, BMI, the level of glucose, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were not significantly different among these subgroups (all P >0 05). (2) The age of patients, BUN, Cr, UA, SBP, LVMI was positively correlated to PP ( r =0 75,0 60,0 70,0 48,0 59, 0 56 respectively, all P <0 05). However, the level of CCr, DBP, FS, and EF were negatively correlated to PP ( r =-0 68,-0 52, -0 49,-0 51 respectively, all P <0 05). (3) The incidence of coronary heart disease, left ventricular hypertrophy, heart failure and cerebral complication were positively correlated to the age of patients, SBP, DBP and PP (all P <0 05), Statistics showed that PP plays a more important role than that of other factors. Conclusions The target organs damage in the essential hypertension was correlated to the age of patients, SBP, DBP, PP. However, PP plays a more important role than other factors in the occurrence of the target organs complication.