【摘要】 目的:定量分析高血压、颈椎病、颈椎病合并高血压患者及正常人的24h动态血压监测数据,观察颈椎病对动态血压的影响。方法:选择2004/2005在山东省通信公司门诊部进行普通健康查体的136例受试者,根据有无高血压和颈椎病分为颈椎病合并高血压组(37例)、原发性高血压组(39例)、颈椎病组(33例)、对照组(27例)。各组之间年龄具可比性,原发性高血压组和颈椎病合并高血压组的体质量指数明显高于颈椎病组和对照组。所有受试者完成常规体检项目后用TM-2421型动态血压监测仪记录24h血压,观察血压均值(包括24h的、白天、夜间的收缩压、舒张压)和血压昼夜节律(夜间血压下降率≥20%为深勺型;≥10%,但<20%为勺型;≥0%,但<10%为非勺型;<0为反勺型,勺型为正常。结果:136例全部进入结果分析。①动态血压均值:颈椎病合并高血压组高于其他3组(P<0.01或0.05);原发性高血压组明显高于对照组和颈椎病组(P<0.01或0.05);颈椎病组的收缩压均值也明显高于对照组(P<0.01)。②昼夜变化模式:反勺型仅出现于原发性高血压组及颈椎病合并高血压组;各组均可见勺型、深勺型及非勺型模式。对照组、颈椎病组、原发性高血压组和颈椎病合并高血压组收缩压勺型模式发生率分别为63.0%,66.7%,38.5%和40.5%,各组比较差异不显著(P>0.05);舒张压勺型模式发生率分别为55.6%,72.7%,43.6%和29.7%,各组比较差异显著(P<0.05),与颈椎病组比,原发性高血压组和颈椎病合并高血压组夜间舒张压下降显著减少(P<0.01或0.05)。结论:颈椎病对动态血压昼夜节律有一定的影响作用。动态血压昼夜勺型变化模式的比例也反映出了高血压的损害性作用及颈椎病可能加重这种损害性的作用。更多还原

【Abstract】 AIM: To investigate the influence of cervical syndrome on ambulatory blood pressure (ABP), analyze quantitatively the 24-hour ABP data in healthy people, hypertensive, cervical syndrome and cervical syndrome complicated with hypertension patients. METHODS: 136 adults, who were given health examination, were selected from Outpatinet Clinic of Shandong Provincial Communication Company between 2004 and 2005. They were divided into four groups:cervical symdrome complicated with hypertension group(CSH,n=37),essential hypertension group(EH,n=39),cervical syndrome group(CS,n=33) and control group(C,n=27)according to with or without hypertension and cervical syndrome. There were no significant age differences among the four groups. Body Mass Index (BMI) in EH group and CSH group were significant higher than that in C and CS groups. TM-2421 Dynamic Blood Pressure Monitors (A&D, Japan) were used for monitoring 24-hour blood pressure after routine health examination. Mean blood pressure (systolic pressure and diastolic pressure in 24 hours, daytime and nighttime) and circadian rhythm of blood pressure (descending rate of blood pressure in nighttime≥ 20% as deep scoop-shape; ≥10%, but < 20% as scoop-shape; ≥ 0%, but < 10% as non-scoop-shape; < 0 as opposite scoop-shape; scoop-shape was normal) were observed. RESULTS: Totally 136 cases were involved in the result analysis. ①Mean value of ABP: It was higher in the CSH group than that in the other 3 groups (P < 0.01 or 0.05). It was higher significantly in the EH group than that in the control group and CS group (P < 0.01 or 0.05). The mean value of systolic pressure in the CS group was also higher obviously than that in the control group (P < 0.01). ②Pattern of day and night change: The opposite scoop-shape only appeared in the EH group and CSH group. The scoop-shape, deep scoop-shape and non-scoop-shape showed in every group. Incidence rate of scoop-shape pattern of systolic pressure was 63.0%, 66.7%, 38.5% and 40.5%, respectively in the control group, CS group, EH group and CSH group, and the difference was insignificant in every group (P > 0.05). Incidence rate of scoop-shape pattern of diastolic pressure was 55.6%, 72.7%, 43.6% and 29.7%, and the difference was obvious in every group (P < 0.05). As compared with the CS group, the decrease of diastolic pressure during nighttime reduced markedly in the EH group and CSH group (P < 0.01 or 0.05=. CONCLUSION: Cervical syndrome has certain influence on circadian rhythm of ABP parameters, and the proportion of pattern of scoop-shape change at day and night also reflects damaging effect of hypertension, while cervical syndrome can stress the damaging effect.更多还原