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目的探讨老年高血压患者血压晨峰与动脉缓冲功能的关系。方法根据24hABPM结果将97例老年患者分为两组,晨峰变异>10mmHg为晨峰组,余非晨峰组。所有受试者行24h动态血压和血管超声检查测得动脉横断面的顺应性(CSC)、动脉可扩张系数(VD)和内皮依赖血管扩张功能(FMD)。结果晨峰组24h、白昼、夜间平均收缩压均保持较高水平,显著高于非晨峰组(P<0.05),而且晨峰组的睡-谷晨峰变异幅度增高有统计学意义(P<0.05)。晨峰组IMT明显高于非晨峰组,差异有统计学意义(P<0.05)。晨峰组的动脉横断面的顺应性、动脉可扩张系数和内皮依赖血管扩张功能均明显低于非晨峰组(P<0.05)。结论老年高血压患者血压晨峰程度和动脉缓冲功能密切相关,是高血压靶器官损害不可忽视的危险因素。
Objective To investigate the relationship between morning blood pressure surge and arterial buffer function in elderly patients with hypertension. Methods According to the results of 24hABPM, 97 elderly patients were divided into two groups. The morning peak variation> 10 mmHg was in the morning peak group and the remaining non-morning peak group. All subjects underwent 24-h ambulatory blood pressure and vascular ultrasound examinations of arterial cross-sectional compliance (CSC), arterial expansion coefficient (VD) and endothelium-dependent vasodilation (FMD). Results The average systolic blood pressure of morning peak group at 24h, daytime and nighttime was higher than that of non-morning peak group (P <0.05), and the amplitude of variation of sleep-valley morning peak in morning peak group was statistically significant (P <0.05 ). IMT in morning peak group was significantly higher than that in non-morning peak group, the difference was statistically significant (P <0.05). The compliance of arterial cross section, arterial expansion coefficient and endothelium dependent vasodilation function in morning peak group were significantly lower than those in non-morning peak group (P <0.05). Conclusions The peak morning blood pressure in elderly hypertensive patients is closely related to the function of arterial buffering, which is a risk factor of target organ damage in hypertension.