摘要
目的研究不同血压模式对高血压病患者血管内皮功能及动脉硬化的影响。方法回顾性分析200例高血压病患者及100例健康人群24 h动态血压参数、颈动脉-股动脉脉搏波速度(CFPwV)水平、内皮功能参数[血栓调节蛋白(TM)、一氧化氮(NO)、一氧化氮合酶(NOS)]等临床资料。高血压病患者根据动态血压水平及夜间血压下降率分为杓型高血压组及非杓型高血压组,每组各100例。比较3组间动态血压参数、CFPwV、TM、NO、NOS的水平,并将各动态血压参数与CFPwV进行多因素回归分析。结果 (1)与正常对照组比较,杓型高血压组、非杓型高血压组各动态血压参数、CFPwV、TM升高,NO、NOS降低(P<0.05);与杓型高血压组比较,在非杓型高血压组夜间平均收缩压(nSBP)、日间平均舒张压(dDBP)、24 h收缩压变异性(24h SBVP)、夜间收缩压变异性(nSBVP)、夜间舒张压变异性(nDBVP)、CFPwV、TM升高,NO、NOS降低(P<0.05)。(2)多因素回归分析结果提示24 h平均收缩压(24h SBP)、日间平均收缩压(dSBP)、nSBP、nDBP、nSBVP、nDBVP是CFPwV升高的独立影响因素。结论 (1)非杓型高血压对内皮功能的损伤较杓型高血压更大,异常高血压模式加速内皮损伤,更易导致动脉硬化。(2)动态血压参数水平与动脉硬化相关,尤其是24h SBP、dSBP、nSBP、nDBP、nSBVP、nDBVP;针对非杓型高血压患者,在降压治疗的同时管理夜间血压水平,纠正异常血压模式具有重要的意义。
Objective To investigate the effect of different blood pressure modes on endothelial function and arteriosclerosis in patients with high blood pressure. Methods A retrospective analysis was made on such clinical data as dynamic blood pressure da-ta, carotid-femoral pulse wave velocity （CFPwV） and the levels of thrombotic TM, nitric oxide （NO） and nitric oxide synthase （NOS） in 200 patients with high blood pressure and 100 normal people. In accordance with dynamic blood pressure level and drop rate of night blood pressure, the patients with high blood pressure were divided into the dipper type hypertension group and the non-dipper type hy-pertension group, each consisting of 100 patients. Then, data of dynamic blood pressure, CFPwV and the levels of TMnNOnNOS were compared between the 3 groups, and multiple-factor regression analysis was made on various dynamic blood pressure data and CFPwV. Results （1） When compared with those of the control group, dynamic blood pressure data, CFPwV and the levels of TM were in-creased ,but the levels of NO and NOS were decreased in the dipper type hypertension group and the non-dipper type hypertension group （P 〈0.05）. Night diastolic blood variation pressure（ nDBVP） , CFPwV and TM were increased, while the levels of NO^NOS were de-creased （P 〈0. 05） . As compared with those of the dipper type hypertension group, nSBP, dDBP, 24hSBVP, nSBVP, nDBVP, CFP-wV and the level of TM were increased, while the levels of NO and NOS were decreased in the non-dipper type hypertension group （P 〈0. 05）. （2） Multiple-factor regression analysis revealed that24hSBP, dSBP, nSBP, nDBP, nSBVP and nDBVP were independ-ent influential factors for the increase of CFPwV. Conclusion （1） The damage to endothelial function in the non-dipper type hyperten-sion group was severer than that in the dipper
出处
《海军医学杂志》
2017年第4期313-316,共4页
Journal of Navy Medicine
关键词
高血压
动脉硬化
动态血压监测
内皮功能
Hypertension
Arteriosclerosis
Dynamic blood pressure monitoring
Endothelial function
