摘要
目的了解高血压病患者肝阳上亢证(Hly)与血压变异性、睡眠时长、睡眠质量的相关性,探讨睡眠对高血压病影响。方法采集251例原发性高血压病患者24 h动态血压、血压变异性指标[收缩压(SBP),舒张压(DBP),脉压(PP)、标准差(SD)、平均(m),白天(d)、夜间(n)]、昼夜节律[下降率(drop)]、血压负荷(L)以及匹茨堡睡眠质量指数量表(PSQI)、睡眠时长、体重指数(BMI)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FPG)、肌酐(Cr)、尿酸(UA)等指标进行数据分析。结果①Hly组喝酒、吸烟、夜睡<6h组、午睡<0.5h组人数构成比高于非Hly组(P<0.05)。②Hly组24hmPP、24hDBPSD、dDBPSD、n SBPSD、nDBPSD均高于非Hly组(P<0.05),Hly组nSBPdrop低于非Hly组(P<0.05),Hly组24hSBPL、24hDBPL、dSBPL、dDBPL、nSBPL、nDBPL高于非Hly组(P<0.05)。③与夜睡<6 h的患者比较,夜睡6~8h和夜睡>8h患者的24hDBPSD、dSBPSD、dDBPSD、nSBPSD、nDBPSD明显降低(P<0.05);与午睡>1 h的患者比较,午睡<0.5h和午睡0.5~1h患者的24hSBPSD、dSBPSD明显降低(P<0.05),午睡<0.5h患者的nSBPSD明显降低(P<0.05)。④与PSQI≥8分的患者比较,PSQI<8分的24hSBPSD、24hDBPSD、dSBPSD、nSBPSD、nDBPSD、nSBPL、24hSBPL明显下降(P<0.05),nSBPdrop、nDBPdrop明显提高(P<0.05)。⑤PSQI指数与24hSBPSD、24hDBPSD、dSBPSD、dDBPSD、nSBPSD、nDBPSD、24hSBL、dSBPL、nSBPL呈正相关(P<0.05),与nSBPdrop、nDBPdrop呈负相关(P<0.05)。结论肝阳上亢证高血压患者存在较大血压变异性,与睡眠不足和睡眠质量差有关。
Objective: To investigate the correlation of the hypertention of hyperactive of liver Yang syndrome(Hly), blood pressure variability, sleep duration and sleep quality, and to explore the effect of sleep on hypertension. Methods: 24 hours(h) ambulatory blood pressure, blood pressure variability [systolic blood pressure(SBP), diastolic blood pressure(DBP), pulse pressure(PP),standard deviation(SD), mean(m), daytime(d), night(n)], circadian rhythm(drop), blood pressure load(L), Pittsburgh sleep quality index(PSQI), sleep duration, body mass Index(BMI), triglyceride(TG), cholesterol(CHOL), high-density lipoprotein cholesterol(HDL), low-density lipoprotein cholesterol(LDL), fasting plasma glucose(FPG), creatinine(Cr), uric acid(UA)were collected from251 patients with essential hypertension for data analysis. Results:① Compared with the non-Hly group, the composition ratio of drinking, smoking, sleeping at night <6 h group and napping <0.5 h group in the Hly group were significantly higher(P<0.05).②24 hmPP, 24 hDBPSD, dDBPSD, nSBPSD and nDBPSD in the Hly group were higher than those in the non-Hly group(P<0.05), nSBPdrop in the Hly group was lower than the non-Hly group(P<0.05). 24 hSBPL, 24 hDBPL, dSBPL, dDBPL, nSBPL in the Hly group nDBPL was higher than the non-Hly group(P<0.05).③ 24 hDBPSD, dSBPSD, dDBPSD, nSBPSD, nDBPSD in the night sleep <6 h group were higher than the night sleep 6-8 h group and the night sleep >8 h group. 24 hSBPSD and dSBPSD in the napping <0.5 h group and napping 0.5-1 h group were lower than the napping >1 h group, and nSBPSD in the napping <0.5 h group was lower than the napping >1 h group(all P<0.05).④ Compared with the PSQI≥8 group, 24 hSBPSD, 24 hDBPSD, dSBPSD, nSBPSD, nDBPSD,nSBPL, 24 hSBPL in the PSQI<8 group were significantly lower,nSBPdrop and nDBPdrop were significantly higher(all P<0.05).⑤ The PSQI index was positively correlated with 24 hSBPSD, 24 hDBPSD, dSBPSD, dDBPSD, nSBPSD, nDBPSD, 24 hSBL, dSBPL,nSBPL, and negatively correlated with nSBPdrop and nDBPdrop(all P<0.05). Conclusion: Hypertensive patients with hyperactivity of liver Yang syndrome have greater blood pressure variability, which is related to insufficient sleep and poor sleep quality.
作者
孟晓嵘
陈秋耘
高原
黄昉萌
郭思薇
吴永希
骆杰伟
魏世超
郑星宇
MENG Xiaorong;CHEN Qiuyun;GAO Yuan;HUANG Fangmeng;GUO Siwei;WU Yongxi;LUO Jiewei;WEI Shichao;ZHENG Xingyu(Aviation General Hospital of China Medical University,Beijing 100012,China;Fujian Provincial Hospital,Fuzhou,Fujian 350001,China;Provincial Clinical Medical College,Fujian Medical University,Fuzhou,Fujian 350001,China)
出处
《福建中医药》
2019年第3期4-9,共6页
Fujian Journal of Traditional Chinese Medicine
基金
福建省中医药科研项目计划(2017FJZYJC105)
关键词
高血压病
血压变异性
肝阳上亢证
睡眠时长
睡眠质量
hypertension
blood pressure variability
hyperactive of liver Yang syndrome
sleep duration
sleep quality
