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目的探讨诊室、随诊间、24h收缩压与老年人颈动脉内膜中层厚度(CIMT)的相关性。方法 2006-2007年第1次对开滦集团公司在职及离退休职工进行健康体检,此后分别于2008-2009、2010-2011年进行第2、3次健康体检,并于第3次体检时整群随机抽取年龄≥60岁的开滦集团离退休员工2814例进行动态血压监测、颈部血管彩色多普勒超声心动图等检查。最终符合入选标准2464人。采用多元逐步线性回归分别分析诊室、随诊间、24h、日间、夜间收缩压与CIMT的关系。结果研究对象2464人,男性1667人,女性797人,平均年龄67.4岁。按照不同收缩压三分位分别将研究对象分为3组,随着不同收缩压水平增加,CIMT显著增厚(均P<0.01)。多元逐步线性回归分析显示:校正混杂因素后,诊室、随诊间、24h、日间、夜间收缩压均与CIMT呈线性正相关,收缩压每增加1mm Hg,CIMT分别增加0.001、0.002、0.002、0.002、0.002mm(均P<0.01)。去除24h收缩压后(存在多重共线性),比较诊室、随诊间、日间、夜间收缩压与CIMT的关联大小的回归结果显示,随诊间、日间收缩压与CIMT呈线性相关,且随诊间收缩压与CIMT的关联大于日间收缩压(β值分别为0.154、0.098)。结论诊室、随诊间、24h、日间、夜间收缩压均与CIMT相关,其中随诊间收缩压与CIMT相关性最大。
Objective To investigate the correlation between systolic blood pressure (24h) and carotid intima-media thickness (CIMT) in the elderly, follow-up clinic and the elderly. Methods The first physical examination of serving and retired staff of Kailuan Group Company from 2006 to 2007 was carried out, and the second and third physical examinations were carried out in 2008-2009 and 2010-2011, respectively. During the third physical examination, The group randomly selected 2814 cases of retired employees of Kailuan Group aged ≥60 years for ambulatory blood pressure monitoring and neck color Doppler echocardiography. Finally meet the inclusion criteria 2464 people. Multivariate stepwise linear regression was used to analyze the relationship between systolic pressure, follow-up, 24h, daytime and nighttime systolic pressure and CIMT respectively. Results The study population was 2464, with 1667 males and 797 females, with an average age of 67.4 years. Subjects were divided into three groups according to different systolic blood pressure tertiles. CIMT was significantly thicker with different systolic blood pressure levels (all P <0.01). Multivariate stepwise linear regression analysis showed that after adjusting for confounding factors, there was a linear positive correlation between systolic blood pressure at clinic, at follow-up, 24h, daytime and nighttime, and CIMT. When the systolic blood pressure was increased by 1mm Hg, CIMT increased by 0.001,0.002,0.002, 0.002 and 0.002 mm (all P <0.01). After 24h systolic pressure was removed (there was multicollinearity), the regression results of the correlation between systolic, diastolic, daytime, nighttime systolic blood pressure and CIMT showed that daytime systolic blood pressure was linearly correlated with CIMT The association between systolic blood pressure and CIMT during follow-up was greater than that during daytime systolic BP (β = 0.154, 0.098, respectively). Conclusions Clinic, follow-up clinic, systolic blood pressure at 24h, daytime and nighttime are all related to CIMT, among which systolic blood pressure has the highest correlation with CIMT.