原发性高血压患者血流介导的血管舒张功能与血压变异性的相关性

发布时间：2018-02-28 18:27

  本文关键词： 内皮功能 动态血压 血压变异性　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨原发性高血压患者血流介导的血管舒张功能与血压变异性的相关性。方法:纳入2015-2016年山西医科大学第一临床附属医院高血压病房的原发性高血压患者113例,收集年龄、性别、身高、体重、高血压病史、服用药物、心率等一般情况,计算体重指数(BMI),全部患者需留取清晨空腹静脉血完善常规化验检查,利用UNEX EF 38G血管内皮功能检测仪测量血流介导的血管舒张功能(flow-mediated vasodilation,FMD),利用美国伟伦动态血压仪进行24h动态血压监测(ambulatory blood pressure monitoring,ABPM)检查,通过24h ABPM收集的数据计算血压变异性(blood pressure variability,BPV)参数[标准差(standard deviation,SD)、变异系数(coefficient of variance,CV)、加权标准差(weighted standard deviation,wSD)、平均实际变异(the average real variability,ARV)]。根据FMD将患者分为FMD正常组(FMD≥6%)和FMD异常组(FMD6%)。采用单因素和多因素线性分析探讨FMD与各因素的相关性。结果:纳入的113名患者包括男性50例,女性63例,平均年龄(57.98±14.98)岁。1.根据FMD分组:FMD异常组的收缩压ARV、收缩压wSD、夜间收缩压SD高于正常组[(11.53±2.85)比(10.07±2.02)mm Hg,(12.48±3.31)比(10.79±2.11)mm Hg,(11.45±4.64)比(8.85±2.00)mm Hg](均P0.05)。2.相关性分析:FMD和年龄、BMI、同型半胱氨酸、收缩压平均水平及收缩压ARV、收缩压wSD、收缩压SD、白天收缩压SD、夜间收缩压SD、收缩压CV、白天收缩压CV、夜间收缩压CV明显相关(r=-0.328,-0.251,-0.223,-0.226,-0.322,-0.364,-0.329,-0.332,-0.318,-0.276,-0.253,-0.234,均P0.05)。3.多元线性回归分析:FMD与收缩压ARV(β=-0.386,P=0.001)、收缩压wSD(β=-0.404,P0.001)、收缩压SD(β=-0.341,P=0.002)、收缩压CV(β=-0.240,P=0.029)相关。结论:原发性高血压患者血流介导的血管舒张功能与收缩压变异性独立相关。
[Abstract]:Objective: to investigate the correlation between blood flow mediated vasodilation function and blood pressure variability in patients with essential hypertension. Methods: 113 patients with essential hypertension were enrolled in the hypertension ward of the first affiliated Hospital of Shanxi Medical University from 2015 to 2016. Collecting age, sex, height, weight, history of hypertension, taking drugs, heart rate, and so on, and calculating body mass index (BMI). All patients need to take fasting venous blood in the morning to complete routine laboratory examination. Vascular endothelium function was measured by UNEX EF38G vascular endothelial function detector. Blood flow mediated vasodilation was measured by flow flow-mediated vasodilation.Ambulatory blood pressure monitoring (ABPM) was performed with the US Viron ambulatory blood pressure meter. The parameters of blood pressure variability (ABPM) were calculated by 24 h ABPM data. The patients were divided into FMD normal group (FMD 鈮，

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