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目的观察不同类型高血压患者脉压、脉压指数与肱踝动脉脉搏波传导速度(baPWV)和踝臂血压指数(ABI)的相关性。方法入选2015年1月至2017年3月初诊为原发性高血压的患者260例为观察组,同期行体检的健康人群220人为对照组。计算和比较对照组与观察组[不同高血压类型:单纯收缩期高血压组(ISH)、单纯舒张期高血压组(IDH)、收缩期舒张期高血压组(SDH);不同脉压:脉压(收缩压-舒张压,mm Hg)≤50组、51~60组、>60组;不同脉压指数(脉压/收缩压):<0.4组、0.4~0.5组、>0.5组]baPWV和ABI水平的差异。结果观察组患者的收缩压、舒张压、脉压和脉压指数高于对照组,baPWV水平高于而ABI水平低于对照组(均P<0.05)。高血压类型中,ISH组baPWV水平最高而ABI水平最低,SDH组与IDH组和对照组baPWV、ABI比较差异有统计学意义(均P<0.05),IDH组和对照组baPWV、ABI比较差异无统计学意义(P>0.05)。不同脉压和脉压指数亚组的baPWV水平与ABI水平存在差异,脉压和脉压指数越大者,baPWV越高而ABI水平越低(均P<0.05)。Pearson线性相关分析显示,baPWV与ABI呈负相关(r=-0.784,P<0.05);调整年龄、BMI、血脂等影响因素后,行偏相关分析,两者仍呈负相关(r=-0.766,P<0.05)。以baPWV或ABI为因变量,年龄、血脂、血压、血糖和BMI为自变量进行多元线性逐步回归分析显示,脉压(β=0.323或β=-0.407)和脉压指数(β=0.352或β=-0.420)是baPWV增加或ABI减少的影响因素(均P<0.05)。结论不同类型高血压患者baPWV和ABI水平存在差异,ISH组baPWV水平最高而ABI水平最低,脉压和脉压指数越大者baPWV越高而ABI水平越低。
Objective To observe the correlation between pulse pressure, pulse pressure index and brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI) in patients with different types of hypertension. Methods One hundred and twenty-six patients newly diagnosed as essential hypertension from January 2015 to March 2017 were selected as observation group and 220 healthy subjects undergoing physical examination during the same period as control group. Comparisons and comparisons between the control group and the observation group [different types of hypertension: isolated systolic hypertension (ISH), simple diastolic hypertension (IDH), systolic diastolic hypertension (SDH) (Systolic-diastolic pressure, mm Hg) ≤50, 51-60,> 60; different pulse pressure index (pulse pressure / systolic pressure): <0.4 group, 0.4-0.5 group,> 0.5 group] baPWV And ABI level differences. Results The systolic blood pressure, diastolic blood pressure, pulse pressure and pulse pressure index of the observation group were higher than those of the control group. The baPWV level was higher than that of the control group (all P <0.05). In the type of hypertension, the levels of baPWV and ABI in ISH group were the highest, while the baPWV and ABI levels in SDH group, IDH group and control group were significantly different (all P <0.05). The difference of baPWV and ABI between IDH group and control group was no significant difference Statistical significance (P> 0.05). The differences of baPWV levels and ABI levels between different pulse pressure and pulse pressure index subgroups were significant. The higher the pulse pressure and pulse pressure index, the higher baPWV and lower ABI (all P <0.05). Pearson linear correlation analysis showed that there was a negative correlation between baPWV and ABI (r = -0.784, P <0.05). After adjustment for age, BMI, blood lipid and other influencing factors, partial correlation analysis showed a negative correlation (r = -0.766 , P <0.05). Multiple linear stepwise regression analysis with baPWV or ABI as dependent variable, age, blood lipid, blood pressure, blood glucose and BMI as independent variables showed that pulse pressure (β = 0.323 or β = -0.407) and pulse pressure index = -0.420) were the influencing factors for the increase of baPWV or the decrease of ABI (all P <0.05). Conclusion The levels of baPWV and ABI in patients with different types of hypertension are different. The levels of baPWV and ABI are the highest in ISH and the higher of pulse pressure and pulse pressure index.