摘要/Abstract

摘要： 目的 · 探讨 24 h 动态血压监测所测得的血压变异性（blood pressure variability，BPV）尤其是血压昼夜节律与臂踝脉搏波传导速度（brachial ankle pulse wave velocity，baPWV）及左心室质量指数（left ventricular mass index，LVMI）的关系。方法 · 共纳入 184 例原发性高血压患者。根据夜间收缩压较日间下降的百分比，将患者分为杓型组、非杓型组、反杓型组和超杓型组。组间比较 baPWV 和 LVMI，对 baPWV 和 LVMI 与血压值和 BPV 指标的关系进行单因素和多因素回归分析。结果 · 校正年龄、体质量指数、高血压病程、诊室血压、24 h 收缩压、24 h 舒张压、总胆固醇、低密度脂蛋白胆固醇、脑钠肽和射血分数后，非杓型组和反杓型组 baPWV 显著高于杓型组和超杓型组（P=0.000），非杓型组的 LVMI 显著高于杓型组（P=0.001）和超杓型组（P=0.022）。在单因素回归分析中，baPWV 及 LVMI 均与与年龄、24 h 收缩压及标准差（SD 值）、日间收缩压及 SD 值、夜间收缩压及 SD 值、24 h 舒张压及 SD 值、日间舒张压及 SD 值、夜间舒张压及 SD 值显著相关（P<0.05）。在多因素线性回归分析中，baPWV 与夜间收缩压 SD 值 (β=0.289，P=0.000)、夜间收缩压的下降百分比 (β=-0.398，P=0.000)、日间收缩压 (β=0.214，P=0.001) 以及日间舒张压的 SD 值 (β=0.207，P=0.002) 相关。LVMI 与 24 h 收缩压 (β=0.348，P=0.000) 以及夜间收缩压 SD 值 (β=0.196，P=0.026) 相关。结论 · 原发性高血压患者 baPWV 与夜间收缩压 SD 值、夜间收缩压下降百分比、日间收缩压以及日间舒张压的 SD 值独立相关；LVMI 与 24 h 收缩压以及夜间收缩压 SD 值独立相关。
关键词: 血压变异性, 24 h 动态血压监测, 血压昼夜节律, 脉搏波传导速度, 左心室质量指数
Abstract:
Objective · To explore the association of blood pressure variability (BPV), especially diurnal blood pressure rhythm with brachial ankle pulse wave velocity (baPWV) and left ventricular mass index (LVMI). Methods · A total of 184 hypertensive patients participated this cross sectional study. Patients were divided into dippers, non-dippers, inverted dippers and extreme dippers groups according to nocturnal systolic blood pressure (SBP) decline. baPWV and LVMI in different groups were compared. Correlation of baPWV and LVMI with blood pressure and BPV variables were analyzed by univariate and multivariate regression analysis. Results · After adjusted by age, BMI, hypertension duration, blood pressure in consulting room, SBP and diastolic blood pressure (DBP) in 24 h, total cholesterol, low density lipoprotein cholesterin, brain natriuretic peptide and ejection fraction, baPWV in non-dippers group and inverted-dippers group were significantly higher than that in dippers group and extreme dippers group (P=0.000), and LVMI was significantly higher in non-dippers group than in dippers group (P=0.001) and extreme-dippers group (P=0.022). baPWV and LVMI were both significantly correlated to age, 24 h SBP and 24 h DBP, SD value of 24 h SBP and 24 h DBP, daytime SBP and DBP, nocturnal SBP and DBP, SD values of daytime SBP and DBP, SD values of nocturnal SBP and DBP in univariate linear regression models (P<0.05). In multivariate linear regression model, baPWV was independently associated to SD value of nocturnal SBP (β=0.289, P=0.000), nocturnal SBP decline (β=-0.398, P=0.000), daytime SBP (β=0.214, P=0.001) and SD value of daytime DBP (β=0.207, P=0.002), while LVMI was independently associated to 24 h SBP (β=0.348, P=0.000) and SD value of nocturnal SBP (β=0.196, P=0.026). Conclusion · baPWV was independently correlated to SD value of nocturnal SBP, nocturnal SBP decline, daytime SBP and SD value of daytime DBP, while LVMI was independently correlated to 24 h SBP and SD value of nocturnal SBP.
Key words: blood pressure variability, 24 h ambulatory blood pressure monitoring, diurnal blood pressure rhythm, brachial ankle pulse wave velocity, left ventricular mass index


PDF全文下载地址:

点我下载PDF