CAJ | 학술논문

目的研究老年高血压患者血压节律改变与颈动脉硬化的关系.方法 193例老年高血压患者根据颈部彩色多普勒超声检查结果分为观察组即颈动脉硬化患者(n=91)和对照组(n=102).患者均给予24h血压动态监测,比较和分析两组血压节律的改变情况.结果观察组与对照组24h平均收缩压(24 h-SBP)、24 h平均舒张压(24 h-DBP)、24h平均脉压(24h-MBP)差异均无统计学意义(均P＞0.05),观察组昼间平均收缩压(d-SBP)、昼间平均舒张压(d-DBP)、昼间平均脉压(d-MBP)、夜间平均收缩压(n-SBP)、夜间平均舒张压(n-DBP)、夜间平均脉压(n-MBP)均显著高于对照组(t=16.92、24.68、6.16、12.87、11.59、6.35,均P＜0.05),观察组组内d-SBP、d-DBP、d-MBP均分别高于与n-SBP、n-DBP、n-MBP,差异有统计学意义(F =73.61,P＜0.01).观察组昼夜血压变异度＞10％,则观察组24 h动态血压曲线图为非杓型曲线；对照组昼夜血压变异度＜5％,则24h动态血压曲线图为杓型曲线.结论老年高血压患者晨压高峰对颈动脉硬化的发生具有临床意义,血压昼夜节律性改变可作为临床治疗和研究的依据.
목적 연구노년고혈압환자혈압절률개변여경동맥경화적관계.방법 193례노년고혈압환자근거경부채색다보륵초성검사결과분위관찰조즉경동맥경화환자(n=91)화대조조(n=102).환자균급여24h혈압동태감측,비교화분석량조혈압절률적개변정황.결과 관찰조여대조조24h평균수축압(24 h-SBP)、24 h평균서장압(24 h-DBP)、24h평균맥압(24h-MBP)차이균무통계학의의(균P＞0.05),관찰조주간평균수축압(d-SBP)、주간평균서장압(d-DBP)、주간평균맥압(d-MBP)、야간평균수축압(n-SBP)、야간평균서장압(n-DBP)、야간평균맥압(n-MBP)균현저고우대조조(t=16.92、24.68、6.16、12.87、11.59、6.35,균P＜0.05),관찰조조내d-SBP、d-DBP、d-MBP균분별고우여n-SBP、n-DBP、n-MBP,차이유통계학의의(F =73.61,P＜0.01).관찰조주야혈압변이도＞10％,칙관찰조24 h동태혈압곡선도위비표형곡선；대조조주야혈압변이도＜5％,칙24h동태혈압곡선도위표형곡선.결론 노년고혈압환자신압고봉대경동맥경화적발생구유림상의의,혈압주야절률성개변가작위림상치료화연구적의거.
Objeetive To investigate the relationship between 24-hour blood pressure rhythm and carotid scleratheroma in elderly patients with hypertension.Methods 193 elderly patients with hypertension were enrolled in the study and divided into study group (91 cases with carotid atherosclerosis) and control group (102 cases).All the patients were given 24h blood pressure rhythm examination.The characteristics of 24hour blood pressure rhythm was compared between the two groups.Results The 24h average systolic blood pressure(24h-SBP),24h average diastolic blood pressure (24h-DBP),24h average pulse pressure (24h-MBP) between the study group and the control group had no significant differences(P ＞ 0.05).The daytime average systolic blood pressure(d-SBP),diurnal mean diastolic blood pressure (d-DBP),diurnal average pulse pressure (d-MBP),nocturnal mean systolic blood pressure (n-SBP),nocturnal mean diastolic blood pressure(n-DBP),nocturnal mean pulse pressure(n-MBP) of the study group were significantly higher than those of the control group (t =16.92,24.68,6.16,12.87,11.59,6.35,all P ＜0.05).In study group,d-SBP,d-DBP,d-MBP were higher than n-SBP,n-DBP,n-MBP,the differences were statistically significant(F =73.61,P ＜ 0.01).The circadian blood pressure variability of the study group was more than 10％,the 24h ambulatory blood pressure curve graph of the study group was non-dipper curve.The circadian blood pressure variability of the control group was less than 5％,the 24h ambulatory blood pressure curve was dipper type curve.Conclusion The MBPS is strongly associated with carotid scleratheroma,and clinical treatment and study could derive from ABPM data analysis.