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目的探讨颈动脉病变与血压昼夜节律变化的关系。方法对595例高血压病患者进行24h无创动态血压监测,并采用超声测定颈动脉内膜中层厚度(IMT)及颈动脉斑块。结果血压节律呈勺形(夜间血压下降>10%)及非勺形(夜间血压下降≤10%)者分别为180例及415例,非勺形血压患者双侧颈总动脉平均IMT为(0.95±0.24)mm,双侧颈总动脉最厚IMT为(1.02±0.31)mm,均显著高于勺形血压患者的(0.90±0.16)mm及(0.94±0.20)mm(P均<0.05),斑块发生率在非勺形血压患者为55.2%,显著高于勺形血压患者的41.7%(P<0.05)。结论非勺形高血压患者颈动脉病变较勺形者为重,血压昼夜节律可能是颈动脉病变的重要影响因素。
Objective To investigate the relationship between carotid artery disease and changes of circadian rhythm of blood pressure. Methods Noninvasive ambulatory blood pressure monitoring was performed on 595 patients with essential hypertension and the carotid intima-media thickness (IMT) and carotid artery plaque were measured by ultrasound. Results The nocturnal blood pressure rhythms were 180 (n = 10) and non-nocturnal (nocturnal normotensives ≤ 10%), respectively. The mean IMT of bilateral common carotid arteries in patients with non-spoon-shaped blood pressure was (0.95 ± 0.24) mm, and the maximum IMT of bilateral common carotid arteries was (1.02 ± 0.31) mm, which were significantly higher than those of scapular blood pressure (0.90 ± 0.16) mm and (0.94 ± 0.20) mm respectively (all P <0.05) The incidence of plaque in non-spoon-shaped blood pressure was 55.2%, significantly higher than spoon-shaped blood pressure in patients with 41.7% (P <0.05). Conclusion Carotid artery lesions are more important in patients with non-spoon-type hypertension than those with spoon-shaped body. The circadian rhythm of blood pressure may be an important influencing factor of carotid artery disease.