【摘要】 目的观察动态血压监测(ABPM)的参数在母系遗传性高血压(MIEH)患者中的特征及变化。方法比较分析52例MIEH患者(研究组)与60例性别、年龄及腰围匹配的散发高血压(EH)患者(对照组)的临床特征及ABPM的参数。结果 (1)两组患者年龄、性别、高血压病程、吸烟率、体质量指数、腰围、血糖、尿酸、血肌酐、血脂比较差异无统计学意义(P>0.05),研究组的颈总动脉内膜中层厚度(I MT)较对照组明显增加,分别为(1.05±0.13)mm与(0.94±0.13)mm(P<0.05)。(2)两组患者24 h、白天和夜间的平均收缩压(SBP)和舒张压(DBP)比较差异无统计学意义(P>0.05),但研究组白天、夜间和24 h的平均脉压(PP)均高于对照组(P<0.05)。(3)研究组中57.7%患者血压昼夜节律消失,与对照组(58.3%)比较差异无统计学意义(P>0.05)。(4)研究组患者对称动态动脉硬化指数(S-AASI)和动态动脉硬化指数(AASI)(0.39±0.09、0.53±0.18)与对照组(0.30±0.09、0.42±0.14)比较差异有统计学意义(P<0.05)。(5)相对危险度分析显示颈总动脉I MT的增厚与母系遗传因素有关(χ2MH=7.409,P<0.01,OR=3.179)。结论 MIEH和散发的EH患者动态血压表型的差别不大,但MIEH患者大动脉弹性功能和血管局部结构变化均比散发EH患者严重。更多还原

【Abstract】 Objective To observe the characteristic and changes of ambulatory blood pressure monitoring(ABPM) in the patients with maternally inherited essential hypertension(MIEH).Methods The clinical features and ABPM parameters of 52 patients with MIEH and 60 gender,age and waist circumference matched sporadic patients with essential hypertension(EH) were compared.They were divided into research group and control group.Results(1) Baseline demographic and laboratory findings were not significantly different between two groups(P>0.05).But the mean intima-media thickness(IMT) of common carotid artery(CCA) was thicker in research group than in control group [(1.05±0.13) mm vs(0.94±0.13) mm,P<0.05)].(2) ABPM showed daytime,nighttime and 24 h average systolic blood pressure(SBP) and diastolic blood pressure(DBP) of the patients with MIEH were not significantly different from those with non-genetic EH(P>0.05).However,average pulse pressure(PP) of 24 h,diurnal and nocturnal were significantly different between two groups(P<0.05).(3) The circadian rhythm of blood pressure disappeared in 57.7% patients with MIEH,which were similar to that in sporadic patients with EH(58.3%).(4) Symmetric ambulatory arterial stiffness index(S-AASI) and ambulatory arterial stiffness index(AASI) of research group were significantly higher than those of control group(0.39±0.09 vs 0.30±0.13 and 0.53±0.18 vs 0.42±0.14,P<0.05).(5) Relative risk analysis with Mantel-Haenszel Chi-square test indicated that CCA-IMT had statistically significant relation with maternal genetic factor(χ2MH=7.409,P<0.01,OR=3.179).Conclusion The main parameters of ABPM were not different between two groups,but the arterial stiffness and vascular structural abnormality of patients with MIEH were significant more severe than those of sporadic patients with EH.更多还原