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目的探讨并分析原发性高血压病患者心率、血压等相关参数与肱踝脉搏波传导速度(baPWV)的关系。方法选择2013年3月至2015年3月在北京航天总医院和北京航空总医院门诊或住院诊断为原发性高血压病的患者280例,采用全自动动脉硬化检测仪测量baPWV,并根据其值分为C组(baPWV<1 400 cm/s,n=168例)和H组(baPWV≥1 400 cm/s,n=112例)。所有患者均进行同步动态血压及动态心电图监测,记录并比较两组患者一般资料、血生化相关指标、心率及血压等相关指标的差异。分别采用Pearson相关性分析和多元线性回归法分析各指标与ba PWV的相关性。结果 H组的血同型半胱氨酸(HCY)、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、24 h平均收缩压、24 h平均脉压(24 h PP)、白昼平均收缩压、夜间平均收缩压、夜间平均脉压、24 h收缩压负荷、24 h收缩压标准差(24 h SSD)、夜间收缩压下降率、24 h收缩压变异系数、每5 min心搏R-R间期均值的标准差和夜间/白天心率比值(n HR/d HR)与C组相比差异有统计学意义(P<0.05);HCY、24 h PP、24 h收缩压负荷、24 h SSD、n HR/d HR与baPWV独立相关(P<0.05),其中HCY、24 h SSD的相关性最强。结论原发性高血压病患者血HCY水平和动态血压、心率部分检测指标与baPWV密切相关,可间接反映动脉弹性功能并作为高血压病血管损害的指标。
Objective To investigate and analyze the relationship between heart rate and blood pressure and brachial-ankle pulse wave velocity (baPWV) in patients with essential hypertension. Methods Two hundred and eighty patients diagnosed as essential hypertension in Beijing Aerospace General Hospital and Beijing Aviation General Hospital from March 2013 to March 2015 were selected and baPWV was measured by automatic arteriosclerosis detector Values were divided into group C (baPWV <1400 cm / s, n = 168) and H group (baPWV≥1 400 cm / s, n = 112). All patients underwent synchronous ambulatory blood pressure and Holter monitoring. The general data of two groups of patients were recorded and compared. The indexes of blood biochemistry, heart rate and blood pressure were recorded and compared. Pearson correlation analysis and multivariate linear regression analysis were used to analyze the correlation between each index and ba PWV. Results The plasma levels of homocysteine (HCY), low density lipoprotein cholesterol, high density lipoprotein cholesterol, average systolic blood pressure at 24 hours, mean systolic blood pressure at 24 hours (24 h PP), systolic blood pressure at daytime, Systolic blood pressure, nocturnal mean pulse pressure, systolic blood pressure at 24 h, standard deviation at 24 h (24 h SSD), rate of decrease of nocturnal systolic pressure, coefficient of variation of systolic blood pressure at 24 h, RR interval averages at 5 min (N HR / d HR) were significantly lower than those in group C (P <0.05); HCY, 24 h PP, 24 h systolic pressure load, 24 h SSD, n HR / d HR was independently associated with baPWV (P <0.05), of which HCY was the strongest at 24 h SSD. Conclusion The levels of HCY, the indexes of ambulatory blood pressure and heart rate in patients with essential hypertension are closely related to baPWV, which can indirectly reflect the function of arterial elasticity and serve as an indicator of vascular damage in hypertensive patients.