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目的探讨老年高血压患者血压变异性(BPV)与颈动脉内膜中层厚度(IMT)及抑郁症的关系。方法选取2014年4-10月于我院老年病科住院的原发性高血压患者128例,行颈动脉超声、24h动态血压监测及焦虑抑郁量表(HAMD)评分。根据颈动脉内膜是否增厚分为IMT正常组(57例)和增厚组(71例),根据是否有抑郁分为抑郁组(59例)和非抑郁组(69例),分别对其动态血压监测结果进行比较。结果 IMT增厚组、IMT正常组昼夜平均收缩压水平及血压形态差异无统计学意义(P>0.05)。抑郁组和非抑郁组昼夜平均收缩压和血压形态差异无统计学意义(P>0.05)。IMT增厚组BPV和抑郁发生率均高于IMT正常组,差异有统计学意义(P<0.05)。抑郁组BPV和IMT增厚率高于非抑郁组,差异有统计学意义(P<0.05)。结论老年高血压患者BPV与颈动脉IMT及抑郁症发生显著相关。降低老年高血压患者BPV对防止颈动脉粥样硬化及抑郁症的发生具有重要的临床意义。
Objective To investigate the relationship between BPV and carotid artery intima-media thickness (IMT) and depression in elderly patients with hypertension. Methods A total of 128 patients with essential hypertension who were hospitalized in our department from April to October 2014 were included in this study. Carotid ultrasound, 24h ambulatory blood pressure monitoring and anxiety and depression scale (HAMD) scores were used. According to whether the intima of the carotid artery was thickened, the IMT normal group (57 cases) and thickening group (71 cases) were divided into depression group (59 cases) and non-depression group (69 cases) Ambulatory blood pressure monitoring results were compared. Results IMT thickening group, IMT normal group day and night average systolic blood pressure and blood pressure morphology was no significant difference (P> 0.05). There were no significant differences in mean systolic blood pressure and blood pressure between depression group and non-depression group (P> 0.05). The incidence of BPV and depression in IMT thickening group were higher than that in IMT normal group, the difference was statistically significant (P <0.05). The thickening rate of BPV and IMT in depression group was higher than that in non-depression group, the difference was statistically significant (P <0.05). Conclusion BPV in elderly patients with hypertension is significantly associated with carotid IMT and depression. Reducing BPV in elderly patients with hypertension has important clinical significance in preventing the occurrence of carotid atherosclerosis and depression.