摘要
目的分析原发性高血压患者动态动脉硬化指数(AASI)的相关影响因素,研究AASI对靶器官的损害作用及其临床意义。方法行24 h动态血压(ABPM)监测并计算AASI的原发性高血压患者330例,依据AASI结果分为低AASI组(n=167)及高AASI组(n=163),记录2组患者的一般临床资料、动态血压相关指标、冠状动脉造影结果、左室质量指数(LVMI),估算肾小球滤过率(eGFR)及踝臂指数(ABI)。结果高AASI组的年龄(岁:64.91±9.70vs 59.12±10.00)、合并糖尿病比例(33.8%vs 14.8%)、非杓型血压比例(65.6%vs 43.7%)、24 h脉压(mmHg:65.27±11.31 vs 56.06±10.51)、24 h舒张压标准差(mmHg:9.64±2.47 vs 8.31±2.31)、冠状动脉病变支数(1.8±1.1 vs 1.3±1.1)、LVMI(g/m2:125.74±29.65 vs 107.69±23.23)、外周血管病变(27.3%vs 16.4%)高于低AASI组;高AASI组eGFR水平小于低AASI组[mL/(min·1.73 m2):85.31±20.31 vs 99.67±17.76]。相关分析显示AASI与冠脉病变数(r=0.235)、LVMI(r=0.168)、外周血管病变(r=0.167)呈正相关,与eGFR(r=-0.187)呈负相关;多元线性回归分析显示年龄、糖尿病、PP、DB-PSD、非杓型血压是AASI的影响因素。结论 AASI受年龄、糖尿病、24 h脉压、血压变异性及血压杓型的影响,其升高和原发性高血压患者出现心、肾及外周血管疾病有关,检测AASI有助于临床医生评估高血压患者并发症的发生和发展。
Objective To investigate the relationship between correlative factors of ambulatory arterial stiffness in-dex （AASI） and target organ damage （TOD） in patients with primary hypertensive. Methods A total of 330 hypertensive pa-tients were included in the study and divided into two groups according to the value of AASI：low AASI group （n=167） and high AASI group （n=163）. The value of AASI was obtained from 24-hour ambulatory blood pressure monitor （ABPM）. The clinical data were collected including general information, the data of ABPM, results of coronary angiography, left ventricular mass index （LVMI）, estimated glomerular filtration rate （eGFR） and ankle brachial index （ABI） in two groups. Results There were significantly higher values of age （years：64.91 ＆#177; 9.70 vs 59.12 ±177; 10.00）, the proportion of diabetes （33.8% vs 14.8%）, the proportion of non-dipper patterns of hypertension （65.6%vs 43.7%）, 24-hour pulse pressure （PP, mmHg：65.27±177; 11.31 vs 56.06±177;10.51）, 24-hour diastolic blood pressure standard deviation（DBPSD, mmHg：9.64±177;2.47 vs 8.31±177;2.31）, the number of coronary artery lesions （1.78±177;1.10 vs 1.27±177;1.07）, LVMI （g/m2：125.74＆#177;29.65 vs 107.69±177;23.23） and the proportion of peripheral vascular disease （27.3%vs 16.4%） in high AASI group than those in low AASI group （P〈0.01）. The level of eGFR was significantly lower in high AASI group than that in low AASI group [mL/（min ＆#183; 1.73 m2）：85.31 ±177; 20.31 vs 99.67 ±177; 17.76]. There were positive correlation between AASI and coronary lesions （r=0.235）, LVMI（r=0.168） and peripheral vascu-lar disease （r=0.167）. And there was a negative correlation between AASI and eGFR （r=-0.187）. The multiple linear regres-sion analysis showed that age, diabetes, PP, DBPSD and non-dipper patterns of hypertension were the predictors of AASI. Conclusion AASI correlated with age, diabetes, PP, blood pressure variability and non-dipper
出处
《天津医药》
CAS
北大核心
2014年第5期477-480,共4页
Tianjin Medical Journal
关键词
高血压
动态动脉硬化指数
靶器官损害
非杓型血压
hypertention
ambulatory arterial stiffness index
target organ damage
non-dipper patterns of hypertension
