CAJ | 학술논문

目的：探讨老年原发性高血压患者7 d 家庭自测血压变异性与血管内皮之间的相关性。方法对来自于健康体检中心体检的142例老年原发性高血压患者进行7 d 家庭自测血压监测及内皮细胞依赖性血管舒张功能（FMD）和内皮非依赖性血管舒张功能（NMD）检测。根据7 d 家庭自测血压变异性（用标准差表示）的三分位，将所有患者分为低变异性组、中变异性组及高变异性组3组。结果高变异性组 FMD 和 NMD 明显低于中及低变异性组，中变异性组明显低于低变异性组，P ＜0．05。FMD 及 NMD 与收缩压变异性（r 分别为－0．635及－0．448，P 均＜0．001）、舒张压变异性（r 分别为－0．187及－0．186，P 均＜0．001）呈负相关。多元线性回归分析显示，在用家庭自测平均收缩压及家庭自测平均舒张压进行校正后，收缩压变异性仍与 FMD 及 NMD 呈显著负相关。结论家庭自测血压变异增高可能是影响血管内皮功能失调的重要因素。
목적：탐토노년원발성고혈압환자7 d 가정자측혈압변이성여혈관내피지간적상관성。방법대래자우건강체검중심체검적142례노년원발성고혈압환자진행7 d 가정자측혈압감측급내피세포의뢰성혈관서장공능（FMD）화내피비의뢰성혈관서장공능（NMD）검측。근거7 d 가정자측혈압변이성（용표준차표시）적삼분위，장소유환자분위저변이성조、중변이성조급고변이성조3조。결과고변이성조 FMD 화 NMD 명현저우중급저변이성조，중변이성조명현저우저변이성조，P ＜0．05。FMD 급 NMD 여수축압변이성（r 분별위－0．635급－0．448，P 균＜0．001）、서장압변이성（r 분별위－0．187급－0．186，P 균＜0．001）정부상관。다원선성회귀분석현시，재용가정자측평균수축압급가정자측평균서장압진행교정후，수축압변이성잉여 FMD 급 NMD 정현저부상관。결론가정자측혈압변이증고가능시영향혈관내피공능실조적중요인소。
Objective To investigate the relationship between variability of 7-day self-measured blood pressure (BP)at home and vascular endothelial function in elderly hypertensive patients.Methods Seven-consecutive-day self-measured blood pressure monito-ring at home,brachial artery flow-mediated dilation (FMD)and nitroglycerin-mediated vasodilatation (NMD)were performed in 142 elderly essential hypertensive patients.Variability of self-measured blood pressure at home was assessed by the standard deviations (SDs)of the daily BP average of the last 6 consecutive days.Based on the level of SD of the daily systolic blood pressure (SBP)aver-age,subjects were categorized into three groups:low home SBP variability group (low group),middle home SBP variability group (middle group),and high home SBP variability group (high group).Results FMD and NMD in high group were significantly lower than those in low and middle group (P <0.05).FMD and NMD in middle group were markedly lower than those in low group (P <0.05).Both FMD and NMD were negatively correlated with SD of self-measured SBP (r = -0.635 and -0.448,P <0.001,re-spectively)and DBP (r = -0.187 and -0.186,P <0.001,respectively).Results After adjusted with self-measured mean SBP and DBP at home and all other covariants,SD of SBP was still negatively correlated with FMD and NMD.Conclusions Excessive variability of self-measured blood pressure at home may be one of the important risk factors for vascular endothelial dysfunction.