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目的:探讨脉压及尿微量白蛋白/肌酐(UACR)与老年单纯收缩期高血压患者主动脉脉搏波传导速度(PWV)的关系。方法:老年单纯收缩期高血压(ISH)患者354例,进行血压、生化指标及UACR测定,应用自动脉搏波传导速度分析仪检测颈—股动脉PWV。将患者分为脉压>60 mmHg(1 mmHg=0.133 kPa)和≤60 mmHg两部分进行分析。按照UACR三分位切点值分三组,UACR<10.34 mg/g组、UACR(10.34～25.60)mg/g组、UACR>25.60 mg/g组,每组118例。结果:①脉压>60 mmHg患者的颈—股动脉PWV比脉压≤60 mmHg患者高(P<0.01),差异有统计学意义。②随UACR值由低到高,三组患者颈—股动脉PWV值逐渐增高,差异有统计学意义(P<0.05)。③多元线性逐步回归分析结果显示:颈—股动脉PWV与年龄、脉压、UACR和高血压病程正相关(P均<0.05)。结论:在老年ISH患者中,脉压和UACR均与主动脉PWV相关联。
Objective: To investigate the relationship between pulse pressure, urinary albumin / creatinine (UACR) and aortic pulse wave velocity (PWV) in elderly patients with isolated systolic hypertension. Methods: A total of 354 elderly patients with isolated systolic hypertension (ISH) were enrolled in this study. Blood pressure, biochemical parameters and UACR were measured. The PWV of neck - femoral artery was measured by automatic pulse wave velocity analyzer. The patients were divided into two groups: pulse pressure> 60 mmHg (1 mmHg = 0.133 kPa) and ≤60 mmHg. UACR tertiles were divided into three groups according to the UACR tertile: UACR <10.34 mg / g, UACR (10.34 ~ 25.60) mg / g and UACR> 25.60 mg / g. Results: ①The PWV of neck-femoral artery in patients with pulse pressure> 60 mmHg was significantly higher than that in patients with pulse pressure ≤60 mmHg (P <0.01). The difference was statistically significant. ②With the UACR value from low to high, the PWV of cervical-femoral artery in three groups gradually increased, the difference was statistically significant (P <0.05). Multiple linear stepwise regression analysis showed that the PWV of neck-femoral artery was positively correlated with age, pulse pressure, UACR and the duration of hypertension (all P <0.05). Conclusions: In elderly patients with ISH, both pulse pressure and UACR are associated with aortic PWV.