CAJ | 학술논문

目的探讨肥胖对老年高血压患者血压变异和及血浆一氧化氮、内皮素的影响.方法选取175例老年高血压患者,根据体质指数分为正常体质量组(69例)、超体质量组(56例)、肥胖组(50例),监测24 h动态血压、一氧化氮、内皮素水平.结果 3组24 h、日间(6:00～22:00)、夜间(22:01～5:59)收缩压与24 h、夜间舒张压差异无统计学意义(均P＞0.05);肥胖组晨峰收缩压较正常体质量组、超体质量组升高(均P＜0.05);肥胖组晨峰舒张压较正常体质量组升高(P＜0.05);肥胖组日间舒张压较超体质量组升高(P＜0.05).肥胖组24 h收缩压变异性、日间收缩压变异性、昼夜节律分别为(12.6±2.7)％、(12.2±2.9)％、(5.2±10.5)％,与超体质量组(10.4±2.2)％、(10.2±2.2)％、(1.4±6.9)％和正常体质量组(9.4±1.9)％、(9.2±2.1)％、(1.8±8.2)％比较,差异有统计学意义(P＜0.05或P＜0.01);肥胖组夜间收缩压变异性、24 h舒张压变异性、日间舒张压变异性分别为(9.8±3.7)％、(15.3±3.3)％、(14.7±3.7)％,与正常体质量组(8.2±3.1)％、(13.2±4.2)％、(12.9±3.8)％比较,差异有统计学意义(均P＜0.05);各组夜间舒张压变异性差异无统计学意义(均P＞0.05).肥胖组一氧化氮较超体质量组、正常体质量组降低[(29.8±14.2)μmol/L比(47.9±18.6)μmol/L、(94.6±42.9)μmol/L,P＜0.01],肥胖组内皮素较超体质量组、正常体质量组升高[(46.5±9.8)ng/L比(37.3±4.8) ng/L、(31.1±5.5) ng/L,P＜0.01].在正常体质量组,24 h收缩压变异性与一氧化氮相关(r=0.340,P=0.004).结论肥胖导致老年高血压患者血压变异性和内皮素升高、一氧化氮降低,是影响血压变异性、内皮素及一氧化氮的重要因素之一.
목적 탐토비반대노년고혈압환자혈압변이화급혈장일양화담、내피소적영향.방법 선취175례노년고혈압환자,근거체질지수분위정상체질량조(69례)、초체질량조(56례)、비반조(50례),감측24 h동태혈압、일양화담、내피소수평.결과 3조24 h、일간(6:00～22:00)、야간(22:01～5:59)수축압여24 h、야간서장압차이무통계학의의(균P＞0.05);비반조신봉수축압교정상체질량조、초체질량조승고(균P＜0.05);비반조신봉서장압교정상체질량조승고(P＜0.05);비반조일간서장압교초체질량조승고(P＜0.05).비반조24 h수축압변이성、일간수축압변이성、주야절률분별위(12.6±2.7)％、(12.2±2.9)％、(5.2±10.5)％,여초체질량조(10.4±2.2)％、(10.2±2.2)％、(1.4±6.9)％화정상체질량조(9.4±1.9)％、(9.2±2.1)％、(1.8±8.2)％비교,차이유통계학의의(P＜0.05혹P＜0.01);비반조야간수축압변이성、24 h서장압변이성、일간서장압변이성분별위(9.8±3.7)％、(15.3±3.3)％、(14.7±3.7)％,여정상체질량조(8.2±3.1)％、(13.2±4.2)％、(12.9±3.8)％비교,차이유통계학의의(균P＜0.05);각조야간서장압변이성차이무통계학의의(균P＞0.05).비반조일양화담교초체질량조、정상체질량조강저[(29.8±14.2)μmol/L비(47.9±18.6)μmol/L、(94.6±42.9)μmol/L,P＜0.01],비반조내피소교초체질량조、정상체질량조승고[(46.5±9.8)ng/L비(37.3±4.8) ng/L、(31.1±5.5) ng/L,P＜0.01].재정상체질량조,24 h수축압변이성여일양화담상관(r=0.340,P=0.004).결론 비반도치노년고혈압환자혈압변이성화내피소승고、일양화담강저,시영향혈압변이성、내피소급일양화담적중요인소지일.
Objective To investigate the effects of obesity on blood pressure variation and plasma levels of nitric oxide (NO) and endothelin (ET) in elderly hypertensive patients.Methods A total of 175 elderly patients with hypertension were screened for this study.Based on body mass index,they were categorized into three groups with normal weight (n =69),overweight (n=56) and obesity (n=50).24 hour dynamic blood pressure,NO and ET levels were monitored.Results No significant differences in 24 h systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,24 hours diastolic blood pressure (24 h-DBP) and night time diastolic blood pressure were found among the groups (all P＞0.05).Morning systolic and diastolic blood pressure were higher in obese group than in normal weight and overweight groups(both P＜0.05).The daytime diastolic blood pressure was higher in obese group than in overweight group.24 h systolic blood pressure variation,daytime systolic blood pressure variation,and blood pressure pattern were higher in obese group than in overweight and normal weight group [(12.6 ± 2.7)％ vs.(10.4 ±2.2)％ and (9.4±1.9)％,(12.2±2.9)％ vs.(10.2±2.2)％ and (9.2±2.1)％,(5.2±10.5)％vs.(1.4± 6.9) ％ and (1.8 ± 8.2) ％ group,all P＜ 0.05].The nighttime systolic blood pressure variation,24 h diastolic blood pressure variation,daytime diastolic blood pressure variation were increased in obese group as compared with normal weight group [(9.8 ± 3.7)％ vs.(8.2 ± 3.1)％,(15.3±3.3)％ vs.(13.2±4.2)％,(14.7±3.7)％ vs.(12.9±3.8)％,all P＜0.05].No differences were found in nighttime diastolic blood pressure variation among the groups.Plasma NO level was lower in obese group than in overweight and normal weight group [(29.8± 14.2)μmol/L vs.(47.9± 18.6) μmol/L and (94.6 ± 42.9) μmol/L,P＜0.01].Plasma ET level was significantly higher in obese group than in overweight group and normal weight group [(46.5± 9.8)ng/L vs.(37.3±4.8) ng/L and (31.1± 5.5) ng/L,P＜0.01].24 h systolic blood pressure variation was significantly correlated with plasma NO level (r =0.340,P =0.004) in normal weight group.Conclusions Obesity can effectively increase blood pressure variation and ET level,and reduce plasma NO level in elderly hypertensive patients.Obesity is one of the most important influencing factors for blood pressure variation,plasma NO and ET levels.