CAJ | 학술논문

目的探讨老年人单纯收缩期高血压(ISH)杓型与非杓型变化对外周动脉和肾脏损害的影响. 方法按照动态血压仪检测结果,共纳入187例老年人,其中ISH非杓型组51例、杓型组70例,平均年龄(72.4±5.6)岁,正常血压对照组66例,平均年龄(71.7±5.3)岁；测定各组踝臂指数(ABI)、肱踝动脉脉搏波传导速度(baPWV)、血视黄醇结合蛋白(RBP)、血胱氨酸蛋白酶抑制剂C(Cystatin C)值. 结果非杓型组baPWV为(1869.3±285.6)cm/s,高于杓型组(1703.1±235.2)cm/s(q=4.73,P＜0.01),非杓型组ABI为1.0±0.2,低于杓型组1.1±0.2(q=4.74,P＜0.01);非杓型组血CystatinC为(1.4±0.5)mg/L,高于杓型组患者的(1.0±0.5)m g/L(q=6.92, P＜0.01),杓型与非杓型ISH组血RBP值均高于对照组,但3组间差异无统计学意义(F=2.39,P＞0.05).当baPWV＞1400 cm/s时,非杓型组和杓型组例数分别为47例和64例,非杓型Cystatin C水平为(1.4±0.5)mg/L,高于杓型组(1.1±0.5)mg/L(q=5.59,P＜0.01). 结论老年人ISH非杓型血压昼夜节律异常较杓型更易发生外周动脉、肾脏损害.
목적 탐토노년인단순수축기고혈압(ISH)표형여비표형변화대외주동맥화신장손해적영향. 방법 안조동태혈압의검측결과,공납입187례노년인,기중ISH비표형조51례、표형조70례,평균년령(72.4±5.6)세,정상혈압대조조66례,평균년령(71.7±5.3)세；측정각조과비지수(ABI)、굉과동맥맥박파전도속도(baPWV)、혈시황순결합단백(RBP)、혈광안산단백매억제제C(Cystatin C)치. 결과비표형조baPWV위(1869.3±285.6)cm/s,고우표형조(1703.1±235.2)cm/s(q=4.73,P＜0.01),비표형조ABI위1.0±0.2,저우표형조1.1±0.2(q=4.74,P＜0.01);비표형조혈CystatinC위(1.4±0.5)mg/L,고우표형조환자적(1.0±0.5)m g/L(q=6.92, P＜0.01),표형여비표형ISH조혈RBP치균고우대조조,단3조간차이무통계학의의(F=2.39,P＞0.05).당baPWV＞1400 cm/s시,비표형조화표형조례수분별위47례화64례,비표형Cystatin C수평위(1.4±0.5)mg/L,고우표형조(1.1±0.5)mg/L(q=5.59,P＜0.01). 결론 노년인ISH비표형혈압주야절률이상교표형경역발생외주동맥、신장손해.
Objective To evaluate periphery artery and renal injury in elderly patients with dipper and non-dipper isolated systolic hypertension(ISH). Methods Totally 187 elderly cases were divided into 51 patients with non-dipper hypertension,70 patients with dipper hypertension aged (72.4±5.6) years and 66 cases with normal blood pressure as control according to results of dynamic blood pressure recorder. Ankle-brachial index (ABI),brachial ankle artery pulse wave velocity (baPWV),retinol-binding protein (RBP) and Cystatin C were assessed. ABI and baPWV were determined by a non-invasive automatic waveform analyzer. Results The baPWV value in nondipper group was higher than dipper group [(1869.3±285.6)cm/s vs.(1703.1±235.2)cm/s,q=4.73,P＜0.01],while the value of ABI in non-dipper group was lower than dipper group (1.0 ±0.2vs.1.1±0.2,q=4.74,P＜0.01).The level of Cystatin C was elevated in non-dipper group versus dipper group [(1.4±0.5) mg/L vs. (1.0±0.5)mg/L,q=6.92,P＜0.01]. There were no differences in RBP concentration among the three groups (F=2.39,P＞0.05).At baPWV＞ 1400cm/s,the level of Cystatin C was increased in 47 cases with non-dipper hypertension as compared with 64 cases with dipper hypertension [(1.4±0.5)mg/L vs.(1.1±0.5)mg/L,q=5.59,P＜0.01].Conclusions The elderly patients with non-dipper hypertension may be more easily suffered from periphery artery and renal injury in comparison with dipper hypertension.