原发性高血压患者血压变异性及血压昼夜节律与颈动脉粥样硬化关系的临床研究

发布时间：2018-07-03 16:21

本文选题：原发性高血压 + 血压变异性　；参考：《安徽医科大学》2013年硕士论文

【摘要】：目的本研究旨在探讨原发性高血压患者血压变异性、血压昼夜节律与颈动脉粥样硬化的关系。方法选取原发性高血压患者84例,其中男性患者47例,女性患者37例;年龄40-86岁,平均年龄(71.68±10.31)岁；应用彩色多普勒超声仪测量所有入选患者颈动脉内-中膜厚度（IMT），并根据检测结果分为硬化组(n=38例)和非硬化组(n=46例)；同时对所有患者行24h动态血压监测，记录24h、白昼、夜间平均血压均值（收缩压、舒张压、脉压均值）以及各时段对应的血压标准差（收缩压标准差及舒张压标准差），根据动态血压监测结果分为勺型组(n=47例)和非勺型组(n=37例)。所有入选患者经询问病史、体检、测定血糖、血脂等生化指标后进行比较。结果 1.硬化组与非硬化组临床及生化指标比较，差异无统计学意义（P＞0.05）。 2.硬化组24hSBP、dSBP、nSBP及24hPP、dPP、 nPP均明显高于非硬化组，差异有统计学意义（P＜0.05或P＜0.01）；而两组间24hDBP、dDBP、nDBP差异无统计学意义（P＞0.05）。 3.硬化组各时段的血压变异性（BPV）及颈动脉内中膜厚度（IMT）均明显高于非硬化组，差异有显著性统计学意义（P＜0.01）。 4. IMT与BPV的相关分析显示，IMT与24hSSD、24hDSD、dSSD、dDSD、nSSD及nDSD均呈正相关(P0．05或P0．01)。 5.与非硬化组比较，硬化组非勺型血压检出率（57.9％）较非硬化组（32.6％）增加(χ~2=5.40, p0.05)。 6.根据动态血压检测结果分组，非勺型组与勺型组临床及生化指标比较，差异无统计学意义（P＞0.05）。 7.非勺型组与勺型组24hSBP、24hDBP、24hPP及dSBP、dhSBP、dPP比较差异无统计学意义，而非杓型组nSBP、nDBP、nPP较杓型组升高（P0.05）； 8.非勺型组的颈动脉内中膜厚度（IMT）及颈动脉粥样硬化检出率也均明显高于勺型组，，差异有统计学意义（P0.01）。结论 1.高血压患者血压变异性及血压昼夜节律与颈动脉粥样硬化形成有关。 2.血压变异性及血压昼夜节律在一定程度上可以作为反映靶器官损害及预测心血管事件的发生的一项重要指标。
[Abstract]:Objective to investigate the relationship between blood pressure variability, circadian rhythm of blood pressure and carotid atherosclerosis in patients with essential hypertension. Methods Eighty-four patients with essential hypertension were selected, including 47 males and 37 females, aged 40-86 years with an average age of (71.68 卤10.31) years. Carotid intima-media thickness (IMT) was measured by color Doppler ultrasound and divided into sclerosing group (n = 38) and non-sclerosis group (n = 46). The nocturnal mean blood pressure (systolic blood pressure, diastolic blood pressure, pulse pressure mean) and the corresponding blood pressure standard deviation (systolic pressure standard deviation and diastolic pressure standard deviation) were divided into ladle type group (n = 47) and non-dipper type group (n = 37) according to the results of ambulatory blood pressure monitoring. All the selected patients were compared after asking for medical history, physical examination, determination of blood sugar, blood lipids and other biochemical indexes. Result 1. There was no significant difference in clinical and biochemical indexes between sclerosing group and non sclerosis group (P > 0.05). In the sclerosing group, the levels of dSBPnSBP, dPPdPPand nPP were significantly higher than those in the non-sclerosing group (P < 0.05 or P < 0.01), but there was no significant difference between the two groups at 24 h (P > 0.05). The blood pressure variability (BPV) and carotid intima media thickness (IMT) in sclerosing group were significantly higher than those in non-sclerosis group (P < 0.01). The correlation analysis between IMT and BPV showed that IMT was positively correlated with 24 h SSDN 24 h DSDN dDSDN nSSD and nDSD (P0.05 or P0.01). Compared with non-sclerosis group, the positive rate of non-dipper blood pressure in sclerosing group (57.9%) was higher than that in non-sclerosis group (32.6%) (蠂 ~ 2 + 5.40, p 0.05). According to the results of ambulatory blood pressure test, there was no significant difference in clinical and biochemical indexes between non-dipper group and dipper group (P > 0.05). There was no significant difference between non-dipper group and dipper type group in 24hSBPnPP and dSBPdhSBPnPP, but the nSBPnPP of non-dipper group was higher than that of dipper group (P0.05). The IMT and the detection rate of carotid atherosclerosis in the non-dipper group were significantly higher than those in the dipper group (P0.01). Conclusion 1. Hypertension patients blood pressure variability and blood pressure circadian rhythm and carotid atherosclerosis formation. 2. Blood pressure variability and circadian rhythm of blood pressure can be used as an important index to reflect the damage of target organs and predict the occurrence of cardiovascular events.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R544.11;R543.4

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