期刊文献+

诊间血压变异性对老年高血压患者血管内皮功能的影响 被引量:20

Impact of visit-to-visit blood pressure variability on vascular function in elderly hypertensive patients
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摘要 目的评价老年高血压患者的诊间血压变异性(blood pressure variability,BPV)与血管内皮功能之间的关系。方法入选174例老年原发性高血压患者,每月门诊测量患者血压,随访12个月,计算每例研究对象随访期间的平均收缩压(SBP)、平均舒张压(DBP)及其标准差、变异系数。随访结束后行超声检查评估血管内皮功能,计算肱动脉的内皮依赖性血流介导的血管舒张功能(flow-mediated vasodilation,FMD)、非内皮依赖性硝酸甘油介导的血管舒张功能(nitroglycerine-mediated vasodilation,NMD)及FMD/NMD,分别按FMD%及FMD/NMD分为内皮功能正常组和内皮功能下降组,比较基线特征及BPV情况。采用多元线性回归分析BPV对血管内皮功能的影响。结果按FMD/NMD分组显示内皮功能下降组的FMD%低于内皮功能正常组,NMD%及血压变异性指标均高于内皮功能正常组,差异均有统计学意义(P<0.05)。内皮功能正常组使用钙离子拮抗剂的比率高于内皮功能下降组(79.55%比63.95%,P<0.05)。多元线性回归分析显示调整年龄、BMI和血压水平之后,BPV与FMD/NMD显著负相关(P<0.05)。结论 FMD/NMD较FMD能更好的反应血管内皮功能,BPV升高的老年高血压病患者存在内皮功能不全。 Objective To assess the relationship between visit- to- visit blood pressure(BP) variability(BPV) and vascular endothelial function in a cohort of elderly hypertensive patients. Methods A total of 174 elderly patients with essential hypertension were included in the study. The participants had their office BP measured during the 12-month follow-up. Right brachial artery diameter was assessed at rest, during reactive hyperemia(flow- mediated dilation, FMD), and after nitroglycerin administration(nitroglycerin- mediated dilation, NMD). The participants were divided into two groups according to FMD% or FMD/NMD ratio. The correlations between BPV and endothelial function were analyzed by univariate analysis and multiple linear regression analysis. Results The participants classified as having a decreased endothelial function according to FMD/NMD ratio had significantly lower FMD% and higher BPV and NMD%(P〈0.05). The percentage of CCBs use in normal endothelial function group was significantly higher than that in decreased endothelial function group(79.55% vs 63.95%, P〈0.05). Multiple linear regression analysis revealed a significant negative association between FMD/NMD ratio and BPV, and this association remained significant after adjustment for age, body mass index, and mean BP levels.Conclusions FMD/NMD ratio is a better marker of endothelial function than FMD, and an increased visit-to-visit variability of BP is associated with a decreased endothelial function.
出处 《南方医科大学学报》 CAS CSCD 北大核心 2015年第9期1320-1324,共5页 Journal of Southern Medical University
基金 深圳市科技计划项目基金(201303003)
关键词 高血压 血压变异性 内皮功能 hypertension blood pressure variability endothelial function
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参考文献15

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