复旦大学硕士学位论文-实用中西医结合临床.DOCVIP

高龄老年高血压患者长时血压变异性与靶器官损害的关系 渠甜甜 （上海市普陀区长寿街道社区卫生服务中心 上海200060） 摘要：目的：探讨高龄老年高血压患者长时血压变异性（Blood Pressure Variability，BPV）与靶器官损害的关系。方法：采用回顾性病例分析研究，选取2015年10月~2016年10月于我中心住院的高龄老年高血压患者共98例，连续7 d测量血压，以收缩压（SBP）值的标准差作为长时BPV的量化指标，将研究对象分为两组：即BPV≥8.80 mm Hg组、BPV＜8.80 mm Hg组，收集患者的临床资料进行分析，探讨高龄老年高血压患者长时BPV与靶器官损害的关系。结果：长时BPV≥8.80 mm Hg组脑卒中患病率、尿蛋白阳性率、SBP、左心室肥厚率、颈动脉内-中膜厚度（IMT）均高于BPV＜8.80 mm Hg组（P＜0.05）；BPV≥8.80 mm Hg组与BPV＜8.80 mm Hg组在性别、年龄、糖尿病患病率、饮酒率、吸烟率、高血压病程、BMI、FBG、TG、TC、LDL-C、HDL-C等指标方面比较，差异无统计学意义（P＞0.05）；对影响IMT的各因素行多元线性回归分析显示，BPV、LDL-C、HDL-C与IMT显著相关（P＜0.05）。结论：高龄老年高血压患者长时BPV与靶器官损害紧密相关，具有很好的心脑血管病预测价值，应当重视对长时BPV的评估。 关键词：原发老年高血压；长时血压变异性；靶器官损害 The Relationship Between Long-term Blood Pressure Variability and Target Organ Damage in Elderly Hypertensive Patients QU Tian-tian (The Department of General Practice, Changshou Street Community Health Service Center of Putuo District, Shanghai200060) Abstract: Objective: To explore the relationship between long-term blood pressure variability (BPV) and target organ damage in elderly hypertensive patients. Methods: 98 Cases of elderly hypertensive patients hospitalized from October 2015 to October 2016 were retrospectively studied. All patientss blood pressure were monitored for 7 consecutive days. The standard deviation of systolic blood pressure (SBP) was considered as a quantitative indicator for long-term BPV. Patients were divided into two groups: BPV≥8.80 mm Hg group and BPV＜8.80 mm Hg group. Clinical data were collected for the investigation of the association between long-time BPV with target organ damage. Results: The prevalence of stroke, positive rate of urinary protein, SBP, positive rate of left ventricular hypertrophy and IMT of long-term BPV≥8.80 mm Hg group were higher than those in BPV＜8.80 mm Hg group (P＜0.05). There was no statistically significant difference between two groups in the indicators of sex, age, prevalence of diabetes, drinking, smoking, duration of hypertension, BMI, FBG, TG, TC, LDL-C and HDL-C. Multiple li