老年高血压患者颈动脉内膜中膜厚度与动态血压参数的相关性

目的:探究老年高血压患者颈动脉内膜中膜厚度(IMT)与动态血压参数间的相关关系,为老年高血压患者的临床治疗提供理论基础。方法:选取2015年1月至2016年1月在我院接受治疗的老年高血压患者204例,根据超声检查结果分为A、B、C三组,每组68例。24 h无创检测患者动态血压参数,包括24h平均收缩压(24h SBP),24 h平均舒张压(24h DBP)、白天平均收缩压(d SBP)、白天平均舒张压(d DBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP),24h脉压(24h PP)及白天脉压(d PP)、夜间脉压(n PP),记录冠心病的发生率、杓型与非杓型高血压比例,利用Person相关性分析IMT与冠心病发生率及动态血压参数的相关性。结果:收缩压和脉压比较差异均有统计学意义(P0.05),其中B组、C组高于A组,C组高于B组,差异具有统计学意义(P0.05)。非杓型高血压在A组占54.41%,B组占60.29%,C组占79.41%,各组间差异有统计学意义(P0.05);A组、B组、C组冠心病发病率分别为41.18%、54.41%和91.18%,组间比较差异有统计学意义(P0.05)。IMT同冠心病发生率和24h SBP、d SBP、n SBP、24h PP、d PP、n PP呈正相关(r=0.876,0.448,0.378,0.476,0.443,0.491,0.438,P0.05)。结论:老年高血压患者收缩压,脉压升高以及非杓型高血压是造成颈动脉内膜中膜厚度增加的主要原因,同时,IMT与冠心病发病率和动态血压参数间呈正相关关系。

Correlation between Carotid Artery Intima Media Thickness and Ambulatory Blood Pressure Parameters in Elderly Patients with Hypertension

Objective:To explore the correlation between carotid artery intima media thickness (IMT) and ambulatory blood pressure parameters in elderly patients with hypertension, and to provide theoretical basis for the clinical treatment of elderly patients with hypertension.Methods:Selected 204 cases of elderly patients with hypertension who treated in our hospital from January 2015 to January 2016, and were divided into three groups of A, B, C by ultrasound results, with 68 cases in each group, 24 h noninvasive detection of ambulatory blood pressure parameters of patients, included the 24 h systolic blood pressure (24 hSBP), 24 average diastolic blood pressure (24 hDBP), average daytime systolic blood pressure(dSBP), daytime DBP(dDBP), nighttime mean systolic blood pressure(nSBP), night average diastolic blood pressure (nDBP), 24 h 24 h pulse pressure (24 hPP)and daytime pulse pressure (dPP), nighttime pulse pressure (nPP), recorded the incidence of coronary heart disease, the proportion of dipper and non-dipper type hypertension. Analyzed the correlation of IMT and coronary heart disease incidence and ambulatory blood pressure parameters by person correlation analysis.Results:The differences of systolic blood pressure and pulse pressure were statistically significant (P<0.05), Group B and group C were higher than A group, C group was higher than B group, the differences were statistically significant (P<0.05). Non dipper hypertension accounted for 54.41%in the A group, B group accounted for 60.29%and C group accounted for 79.41%, there were significant differences between the groups (P<0.05); The incidence of coronary heart disease in group A, group B and group C were 41.18%, 54.41%and 91.18%respectively, There were significant difference between groups (P<0.05). IMT was positively correlated with incidence of coronary heart disease, 24 hSBP, dSBP, nSBP, 24hPP, dPP and nPP (r=0.876, 0.448, 0.378, 0.476, 0.443, 0.491, 0.438, P<0.05).Conclusion:The systolic blood pressure, pulse pressure increased and non dipper hypertension is the main causes of carotid intima-media thickness increased in elderly hypertensive patients, at the same time, IMT was positively correlated with the incidence of coronary heart disease and ambulatory blood pressure parameters.