【作者】 罗辉；

【导师】 张赛丹；

【作者基本信息】 中南大学 ， 内科学， 2008， 硕士

【摘要】 目的:探讨原发性高血压病血压变异性(blood pressure variabilityBPV)与大动脉弹性(脉搏波传导速度pulse wave velocity PWV)的关系。方法:对原发性高血压患者111例(平均年龄55岁)及健康对照组30例,采用PP-1000动脉弹性检测仪检测主动脉脉搏波传导速度(PWV),并行24小时非侵入性动态血压测定。原发性高血压患者按PWV测得值分为:PWV正常组(PWV＜9.0M/S 35例)和PWV升高组(PWV≥9.0M/S 76例)。对反映血压变异性的各时段(24小时、日间及夜间)收缩压及舒张压标准差、血压晨峰进行组间比较,动态血压指标与PWV之间的相关性采用单因素直线相关分析,并采用多元线性逐步回归分析(a_入=0.05;a_出=0.10)对PWV的影响因子进行筛选。结果:1.PWV在原发性高血压组显著高于健康对照组(P＜0.01)。2.原发性高血压组中24小时平均收缩压及舒张压、24小时及日间收缩压标准差、血压晨峰(MBPS)显著高于健康对照组(P＜0.01)。3.原发性高血压病人PWV升高组24小时平均收缩压及舒张压、24小时及日间收缩压标准差、血压晨峰(MBPS)、高血压病程、低密度脂蛋白胆固醇显著高于PWV正常组(P＜0.01或0.05)。4.单因素直线相关分析显示在原发性高血压患者中年龄、24小时平均收缩压及舒张压、24小时及日间收缩压标准差、血压晨峰(MBPS)、低密度脂蛋白胆固醇与PWV显著正相关。5.在原发性高血压患者中以PWV为应变量,以年龄、高血压病程、体重指数、低密度脂蛋白胆固醇、血肌酐、24小时平均收缩压及舒张压、各时段(24小时、日间及夜间)收缩压及舒张压标准差、血压晨峰为自变量进行多元线性逐步回归分析显示年龄、24小时平均收缩压、血压晨峰为PWV的独立影响因素。结论:1.原发性高血压病人主动脉脉搏波传导速度(PWV)显著高于健康人。2.原发性高血压病人动态血压均值中的24小时平均收缩压及舒张压与PWV显著正相关,其中24小时平均收缩压为PWV的独立影响因素。3.反映原发性高血压病人血压变异性的指标——24小时及日间收缩压标准差、血压晨峰与PWV亦呈显著正相关,其中血压晨峰为PWV的独立影响因素。更多还原

【Abstract】 Objective : To investigate the relationship between blood pressure variability and aortic pulse wave velocity in patient with essential hypertension.Methodsr:111 patient with essential hypertension and 30 healthy subjects (as normal control group ) were enrolled in this study. The patient were divided into two groups according to the degree of PWV:PWV normal group(35 patient , PWV less than 9.0m/s ) and PWV abnormal group(76 patient , PWV no less than 9.0m/s ). Ambulatory blood pressure monitoring and aortic PWV were examined .Blood pressure variability and PWV were compared between groups. The relationship between blood pressure variability and PWV were analysed with pearson correlation and multiple linear regression.Result: 1.PWV in essential hypertensive group was significantly higher than that in normal groups(P<0.01). 2.24hSBP,24hDBP, 24hSBP-SD,DBP-SD,MBPS in essential hypertensive group were significantly higher than that in control groups(P<0.05 or P<0.01) .3. 24hSBP,24hDBP, 24hSBP-SD,DBP-SD,MBPS,duration of hypertension, LDL in PWV abnormal group were significantly higher than that in PWV normal group(P<0.05 or P<0.01).4. Pearson correlation analysis showed that age, LDL ,24hSBP,24hDBP,24hSBP-SD,DBP-SD,MBPS were significantly related to PWV.5. Multiple linear regression showed that age,24hSBP,MBPS were significantly and independently factors for PWV in hypertensive patient.Conclusion: 1.Aortic pulse wave velocity(PWV) in patient with essential hypertension was higher than healthy subjects. 2. 24hSBP and 24hDBP were significantly related to PWV, 24hSBP was significantly and independently factor for PWV in hypertensive patient..3. 24hSBP-SD,DBP-SD and MBPS were significantly related to PWV,MBPS was significantly and independently factors for PWV in hypertensive patient.更多还原