摘要目的 探讨老年高血压患者颈动脉斑块的发生与血压变异性(BPV)之间的相关性.方法 入选160例门急诊老年高血压患者,经颈动脉超声检查分为颈动脉斑块组和无斑块组,对两组患者进行24 h动态血压检测,计算并比较两组全天、白天以及夜间的平均血压、平均脉压、血压变异系数.并对颈动脉斑块的相关因素进行多因素Logistic回归分析.结果 老年高血压合并颈动脉斑块组24 h平均收缩压标准差、白昼及夜间平均收缩压标准差、白昼平均舒张压标准差高于无斑块组,差异有统计学意义(P ＜0.05);24 h平均收缩压变异系数、夜间平均收缩压变异系数高于无斑块组,差异有统计学意义(P＜0.01).Logistic回归分析结果显示在老年高血压患者中,24h平均收缩压变异系数及夜间收缩压变异系数是颈动脉斑块的独立影响因素(P＜0.05).结论 老年高血压患者合并颈动脉斑块的发生与24h平均收缩压变异系数、夜间血压变异性有密切的相关性.

abstractsObjective To investigate the correlation between carotid artery plaque and blood pressure variability (BPV) in elderly patients with hypertension.Methods One hundred sixty elderly patients with hypertension were divided into plaque and non-plaque groups according to the results of carotid artery ultrasonography.All the patients were measured by ambulatory blood pressure monitoring.The mean blood pressure,mean pulse pressure,and blood pressure variability coefficient of two groups were calculated and compared during whole day,daytime,and nighttime.The related factors of carotid artery plaque were analyzed by multivarite logistic regression analysis.Results The 24 h systolic blood pressure standard deviation,daytime and nighttime of systolic blood pressure standard deviation,daytime diastolic blood pressure standard deviation of plaque group were higher than those of non-plaque group (P ＜ 0.05).The 24 h systolic blood pressure variation (24 h SBPV) and night systolic blood pressure variation (nSBPV) were higher than those of non-plaque group (P ＜0.01).Multivariate regression analysis results showed that carotic artery plaque was associated positively with 24 h BPV and blood pressure variability coefficient of nighttime (P ＜ 0.05).Conclusions The elderly hypertensive patients with carotid artery plaque is associated positively with 24 h systolic blood pressure variability coefficient and blood pressure variability of nighttime.