论文部分内容阅读
目的:探讨高血压患者血压变异性(BPV)与高敏C反应蛋白(hs-CRP)及颈动脉内膜中层厚度(IMT)的关系。方法:依据夜间收缩压标准差的三分位间距将126例高血压患者分为低BPV组、中BPV组和高BPV组。彩色多普勒超声仪测定IMT和颈动脉斑块,同时检测血浆hs-CRP和血管紧张素转化酶(ACE)。结果:高BPV组hs-CRP水平和IMT较低BPV组增加[hs-CRP:(3.78±3.63)mg/L∶(2.24±1.92)mg/L;IMT:(1.01±0.16)mm∶(0.91±0.17)mm;均P<0.05]。24h血压不达标亚组IMT较达标亚组明显增加[(1.00±0.19)mm∶(0.93±0.16)mm,P<0.05],而hs-CRP和ACE差异无统计学意义。IMT增厚者夜间收缩压标准差大于IMT正常组[(11.13±4.19)mmHg(1mmHg=0.133kPa)∶(9.69±3.24)mmHg,P<0.05]。IMT与24h平均收缩压(mSBP)、白天mSBP、夜间mSBP、夜间收缩压标准差、夜间舒张压标准差及LDL呈正相关(r分别为0.218、0.211、0.210、0.176、0.191、0.267,均P<0.05),多元线性回归分析显示IMT与24hmSBP及LDL有关。结论:高血压患者BPV与颈动脉IMT及hs-CRP密切相关。
Objective: To investigate the relationship between blood pressure variability (BPV) and high-sensitivity C-reactive protein (hs-CRP) and carotid artery intima-media thickness (IMT) in hypertensive patients. Methods: 126 hypertensive patients were divided into low BPV group, moderate BPV group and high BPV group according to the tertile of standard deviation of night systolic pressure. Color Doppler ultrasound was used to measure IMT and carotid artery plaque, meanwhile plasma hs-CRP and angiotensin converting enzyme (ACE) were detected. Results: The hs-CRP levels in high BPV group and the lower BPV group in IMT increased (hs-CRP: 3.78 ± 3.63 mg / L vs 2.24 ± 1.92 mg / L, IMT: 1.01 ± 0.16 mm: ± 0.17) mm; all P <0.05]. The level of IMT in non-standard blood pressure 24h group was significantly higher than that in the standard subgroup [(1.00 ± 0.19) mm: (0.93 ± 0.16) mm, P <0.05], but there was no significant difference between hs-CRP and ACE. The standard deviation of nocturnal systolic pressure in patients with IMT thickening was larger than that in IMT normal group [(11.13 ± 4.19) mmHg (1mmHg = 0.133kPa): (9.69 ± 3.24) mmHg, P <0.05]. IMT was positively correlated with mean systolic blood pressure at 24h, mSBP at daytime, mSBP at night, standard deviation of nocturnal systolic pressure, standard deviation of nocturnal diastolic blood pressure and LDL (r = 0.218,0.211,0.210,0.176,0.191,0.267, P < 0.05). Multiple linear regression analysis showed that IMT was related to 24hmSBP and LDL. Conclusion: BPV is closely related to carotid IMT and hs-CRP in hypertensive patients.