中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
2期
156-159
,共4页
王吉%伊双艳%秦爱梅%王浩%朱兵%王津%孙洪良%张洋%胡智%杜凯音%骆雷鸣
王吉%伊雙豔%秦愛梅%王浩%硃兵%王津%孫洪良%張洋%鬍智%杜凱音%駱雷鳴
왕길%이쌍염%진애매%왕호%주병%왕진%손홍량%장양%호지%두개음%락뢰명
高血压病%老年%血压晨峰%卒中%左心室肥厚%颈动脉内膜中层厚度
高血壓病%老年%血壓晨峰%卒中%左心室肥厚%頸動脈內膜中層厚度
고혈압병%노년%혈압신봉%졸중%좌심실비후%경동맥내막중층후도
Hypertension%Elderly%Morning blood pressure surge%Stroke%Left ventricular hypertrophy%Carotid intima-media thickness
目的：探讨老年原发性高血压病患者血压晨峰（MBPS）与发生卒中、左心室肥厚及颈动脉内膜中层增厚的关系。方法对280例接受抗高血压治疗的老年高血压病患者，以进行24h动态血压监测（ABPM），结果分为：晨峰组患者96例（MBPS≥35 mmHg），非晨峰组患者184例（MBPS＜35 mmHg）。采集患者卒中病史，同时行超声心动图及颈动脉超声检查。检测并记录两组患者血脂、血糖、肾功能等指标，探讨血压晨峰与发生卒中、左心室肥厚、双侧颈动脉内膜中层厚度（IMT）的关系。结果晨峰组患者卒中发生率为40.6%，非晨峰组发生率为28.3%，两组卒中发生率有统计学差异（P＜0.01）。晨峰组左心室肥厚发生率54.2%，非晨峰组发生率为40.2%，两组左心室肥厚发生率有统计学差异（P＜0.05）；晨峰组颈动脉内膜增厚发生率为65.6%，非晨峰组发生率为52.7%，两组颈动脉IMT增厚发生率有统计学差异（P＜0.05）。结论老年高血压血压晨峰患者卒中、左心室肥厚、颈动脉IMT增厚发生率增高，降压治疗的同时应积极治疗血压晨峰，减少靶器官损害。
目的：探討老年原髮性高血壓病患者血壓晨峰（MBPS）與髮生卒中、左心室肥厚及頸動脈內膜中層增厚的關繫。方法對280例接受抗高血壓治療的老年高血壓病患者，以進行24h動態血壓鑑測（ABPM），結果分為：晨峰組患者96例（MBPS≥35 mmHg），非晨峰組患者184例（MBPS＜35 mmHg）。採集患者卒中病史，同時行超聲心動圖及頸動脈超聲檢查。檢測併記錄兩組患者血脂、血糖、腎功能等指標，探討血壓晨峰與髮生卒中、左心室肥厚、雙側頸動脈內膜中層厚度（IMT）的關繫。結果晨峰組患者卒中髮生率為40.6%，非晨峰組髮生率為28.3%，兩組卒中髮生率有統計學差異（P＜0.01）。晨峰組左心室肥厚髮生率54.2%，非晨峰組髮生率為40.2%，兩組左心室肥厚髮生率有統計學差異（P＜0.05）；晨峰組頸動脈內膜增厚髮生率為65.6%，非晨峰組髮生率為52.7%，兩組頸動脈IMT增厚髮生率有統計學差異（P＜0.05）。結論老年高血壓血壓晨峰患者卒中、左心室肥厚、頸動脈IMT增厚髮生率增高，降壓治療的同時應積極治療血壓晨峰，減少靶器官損害。
목적：탐토노년원발성고혈압병환자혈압신봉（MBPS）여발생졸중、좌심실비후급경동맥내막중층증후적관계。방법대280례접수항고혈압치료적노년고혈압병환자，이진행24h동태혈압감측（ABPM），결과분위：신봉조환자96례（MBPS≥35 mmHg），비신봉조환자184례（MBPS＜35 mmHg）。채집환자졸중병사，동시행초성심동도급경동맥초성검사。검측병기록량조환자혈지、혈당、신공능등지표，탐토혈압신봉여발생졸중、좌심실비후、쌍측경동맥내막중층후도（IMT）적관계。결과신봉조환자졸중발생솔위40.6%，비신봉조발생솔위28.3%，량조졸중발생솔유통계학차이（P＜0.01）。신봉조좌심실비후발생솔54.2%，비신봉조발생솔위40.2%，량조좌심실비후발생솔유통계학차이（P＜0.05）；신봉조경동맥내막증후발생솔위65.6%，비신봉조발생솔위52.7%，량조경동맥IMT증후발생솔유통계학차이（P＜0.05）。결론노년고혈압혈압신봉환자졸중、좌심실비후、경동맥IMT증후발생솔증고，강압치료적동시응적겁치료혈압신봉，감소파기관손해。
Objective To investigate the relationship between morning blood pressure surge (MBPS) and stroke, left ventricular hypertrophy (LVH) and carotid intima-media thickness (CA-IMT) in elderly patients with essential hypertension. Methods The aged hypertensive patients (n=280) treated with anti-hypertension therapy were given 24-h ambulatory blood pressure monitoring (ABPM) and divided into MBPS group (n=96, MBPS≥35 mmHg) and non-MBPS group (n=184, MBPS<35 mmHg). The data of stroke history was collected from the patients, and all patients were given echocardiogram and carotid artery ultrasound examinations. The indexes of blood fat, plasma glucose and renal function were detected and recorded in 2 groups. The relationship between MBPS and stroke, LVH and CA-IMT was investigated. Results The incidence rate of stroke was 40.6%in MBPS group and 28.3%in non-MBPS group (P<0.01). The incidence rate of LVH was 54.2%in MBPS group and 40.2%in non-MBPS group (P<0.05). The incidence rate of CA-IMT incrassation was 65.6%in MBPS group and 52.7%in non-MBPS group (P<0.05). Conclusion The incidence rates of stroke, LVH and CA-IMT incrassation will increase in elderly patients with MBPS of essential hypertension, so at the same time of anti-hypertension, MBPS should be controlled for relieving target organ damage.
