摘要
目的:探讨老年高血压病患者高脉压与靶器官损害的关联性以及可行的干预途径。方法:选择2003-06/2004-05在北京市第六医院住院的老年原发性高血压患者230例,年龄60～91岁,男89例,女141例。符合1999年《中国高血压防治指南》中所定高血压诊断标准,排除继发性高血压、糖尿病及其他一些影响脉压的疾病患者。根据动态全天平均脉压分两组,高脉压组128例,脉压≥60mmHg(1mmHg=0.133kPa);对照组102例,脉压<60mmHg(1mmHg=0.133kPa)。分别进行24h动态血压、心电图、超声心动、颈动脉超声、胸部X线、头颅CT、血肌酐及尿白蛋白检测。结果:进入结果分析保持为230例。①高脉压组颈动脉斑块发生率高于对照组66.4%,42.2%(t=2.01,P<0.05)。②高脉压组颈动脉内-中膜厚度、室间隔厚度、左室后壁厚度、左室舒张末期内径均明显高于对照组(0.84±0.19),(8.67±0.98),(8.78±1.05),(49.60±6.61)mm;(0.76±0.04),(7.90±0.99),(7.70±0.48),(46.70±3.09)mm(t=3.82～9.00,P<0.01)。③高脉压组血肌酐、尿白蛋白也明显高于对照组(82.90±16.24)mol/L,(6.00±8.28)mg/L,(76.83±9.54)mol/L,(3.75±7.44)mg/L(t=3.13,3.95,P<0.01,0.05)。④而高脉压组左室射血分数小于对照组(61.33±10.62)%,(64.40±10.24)%,(t=2.07,P<0.05)。
AIM:To investigate the association between the high pulse pressure and the damage of target organ in elderly hypertensive patients,and discuss the feasible interventional methods. METHODS:Totally 230 elderly patients(89 males and 141 females) with essential hypertension at 60 to 91 years of age,who were hospitalized in Beijing Sixth Hospital between June 2003 and May 2004,were divided into two groups according to the levels of ambulatory pulse pressure:high pulse pressure group[pulse pressure ≥60 mm Hg(1 mm Hg=0.133 kPa),n=128] and control group(pulse pressure < 60 mm Hg,n=102).All the patients were in accordance with the diagnostic criteria of hypertension set by The Guidelines for Prevention and Treatment for Hypertension in China in 1999;Those with secondary hypertension,diabetes and other diseases that affected pulse pressure were excluded.Patients in both groups received 24-hour ambulatory blood pressure monitoring,electrocardiography,echocardiogram,carotid ultrasonography,chest X-ray,cerebral CT,detections of serum creatinine and urinary albumin. RESULTS:All the 230 cases were involved in the analysis of results.①The incidence rate of carotid artery plaque was higher in the high pulse pressure group than in the control group(66.4%,42.2%,t=2.01,P< 0.05).②The intimal medial thickness(IMT),thickness of interventricular septum,left ventricular posterior wall thickness,and left ventricular end-diastolic diameter in the high pulse pressure group[(0.84±0.19),(8.67±0.98),(8.78±1.05),(49.60±6.61) mm] were obviously higher than those in the control group[(0.76±0.04),(7.90±0.99),(7.70±0.48),(46.70±3.09) mm](t=3.82 to 9.00,P< 0.01).③Serum creatinine and urinary albumin were markedly higher in the high pulse pressure group[(82.90±16.24) mol/L,(6.00±8.28) mg/L] than in the control group[(76.83±9.54) mol/L,(3.75±7.44) mg/L](t=3.13,3.95,P< 0.01,0.05).④Left ventricular ejection fraction in the high pulse pressure group was lower than that in the control group[(61.33 ±10.62)%,(64.40±10.24)%](t=2.07,P< 0.05).⑤The high pulse pressure group had more patients with left ventricular dilatation by chest X-ray and cases with positive stroke(69 cases,48 cases) than the control group(31 cases,21 cases)(χ2=5.16,4.24,P< 0.05). CONCLUSION:Elderly hypertensive patients with high pulse pressure have more obvious damage of target organs,such as heart,brain,kidney and so on.Ameliorations of their arterial elasticity,controlling and decreasing their pulse pressure play roles in the preventive secondary intervention.
出处
《中国临床康复》
CSCD
北大核心
2005年第15期84-85,共2页
Chinese Journal of Clinical Rehabilitation
