CAJ | 학술논문

目的：研究老年男性杓型高血压晨峰（ MBPS）现象与踝肱指数（ ABI）、尿微量白蛋白/肌酐（ UmAlb/Cr）的关系，探讨老年男性杓型高血压MBPS对动脉粥样硬化的影响。方法251例老年男性杓型高血压患者，根据动态血压监测（ ABPM）结果，分为MBPS组及NMBPS组，所有患者均进行ABI、UmAlb/Cr检测，并常规检测血尿素氮（ BUN）、肌酐（ Cr）、血糖（ Glu）、高密度脂蛋白胆固醇（ HDL-C）、低密度脂蛋白胆固醇（ LDL-C）、甘油三酯（ TG）、总胆固醇（ TCH），分析比较两组患者ABI、UmAlb/Cr的差异。结果两组患者在性别构成比、年龄、吸烟、高血压病程、BUN、Cr、Glu、HDL 17.42比128.21±16.37、98.25±10.08比95.35±9.87、98.76±8.22比94.37±8.95、29.59±4.26比19.02±3.98）， MBPS组ABI显著低于NMBPS组（0.73±0.09比1.02±0.09），MBPS组UmAlb/Cr显著高于NMBPS组（4.79±1.93比4.21±1.56），MBPS组PAD发生率、UmAlb/Cr阳性率显著高于NMBPS组（88/63比52/48、72/79比41/59），差异具有统计学意义（ P ﹤0.05）。SPEARMAN相关分析显示，MBPS与ABI、UmAlb/Cr呈中度相关，与年龄呈低度相关，差异具有统计学意义（ P ﹤0.05）。结论老年男性杓型高血压MBPS是导致PAD以及早期肾损害的重要的危险因素，对动脉粥样硬化产生重要影响。
목적：연구노년남성표형고혈압신봉（ MBPS）현상여과굉지수（ ABI）、뇨미량백단백/기항（ UmAlb/Cr）적관계，탐토노년남성표형고혈압MBPS대동맥죽양경화적영향。방법251례노년남성표형고혈압환자，근거동태혈압감측（ ABPM）결과，분위MBPS조급NMBPS조，소유환자균진행ABI、UmAlb/Cr검측，병상규검측혈뇨소담（ BUN）、기항（ Cr）、혈당（ Glu）、고밀도지단백담고순（ HDL-C）、저밀도지단백담고순（ LDL-C）、감유삼지（ TG）、총담고순（ TCH），분석비교량조환자ABI、UmAlb/Cr적차이。결과량조환자재성별구성비、년령、흡연、고혈압병정、BUN、Cr、Glu、HDL 17.42비128.21±16.37、98.25±10.08비95.35±9.87、98.76±8.22비94.37±8.95、29.59±4.26비19.02±3.98）， MBPS조ABI현저저우NMBPS조（0.73±0.09비1.02±0.09），MBPS조UmAlb/Cr현저고우NMBPS조（4.79±1.93비4.21±1.56），MBPS조PAD발생솔、UmAlb/Cr양성솔현저고우NMBPS조（88/63비52/48、72/79비41/59），차이구유통계학의의（ P ﹤0.05）。SPEARMAN상관분석현시，MBPS여ABI、UmAlb/Cr정중도상관，여년령정저도상관，차이구유통계학의의（ P ﹤0.05）。결론노년남성표형고혈압MBPS시도치PAD이급조기신손해적중요적위험인소，대동맥죽양경화산생중요영향。
Objective To study the relationship between ankle brachial index( ABI),UmAlb / Cr and morning blood pressure surge ( MBPS),and to investigate the impact of MBPS on atherosclerosis in elderly male patients with dipper essential hypertension. Methods Totally 251 elderly male patients with dipper essential hypertension were divided into MBPS group(observation group,n=151)and NMBPS group(control group,n=100)according to the results of ambulatory blood pressure monitoring(ABPM). The ABI,UmAlb/Cr ratio,as well as blood urea ni_trogen(BUN),creatinine(Cr),glucose(Glu),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride(TG)and total cholesterol(TCH)were routine detected. The differences of ABI and UmAlb/Cr in the two groups were ana_lyzed. Results There were no statistical significance in gender composition ratio,age,smoking,course of hypertension,BUN,Cr,Glu,HDL-C,LDL-C,TG and TCH between the two groups( P ﹥0. 05). Compared with NMBPS group,the 24 hSBP,dSBP,nSBP,24 hMAP,dMAP, and the amplitude of variation in morning systolic pressure peak were higher in MBPS group than those in NMBPS group(144. 23 ± 12. 59 vs. 136. 35 ± 14. 21,145. 01 ± 14. 33 vs. 135. 79 ± 15. 26,135. 08 ± 17. 42 vs. 128. 21 ± 16. 37,98. 25 ± 10. 08 vs. 95. 35 ± 9. 87,98. 76 ± 8. 22 vs. 94. 37 ± 8. 95,29. 59 ± 4. 26 vs. 19. 02 ± 3. 98),the ABI was significantly lower than NMBPS group(0. 73 ± 0. 09 vs. 1. 02 ± 0. 09),and the UmAlb/Cr was significantly higher than NMBPS group(4. 79 ± 1. 93 vs. 4. 21 ± 1. 56),as well as the PAD incidence and UmAlb/Cr positive rate were much higher in MBPS group than those in NMBPS group(88/63 vs. 52/48,72/79 vs. 41/59),the differences were statistically signifi_cant( P ﹤0. 05). Pearson correlation analysis showed that MBPS was moderately correlated with ABI,UmAlb/Cr,and it was lowly correlated with age,the differences were statistically significant( P ﹤0. 05). Conclusion The MBPS in elderly patients with dipper essential hypertension was an important risk factor to cause PAD and early kidney damage,and it had a critical impact on atherosclerosis.