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目的:探讨动态脉压及其指数与高血压患者颈动脉内膜-中层厚度(IMT)的关系。方法:测量159例研究对象的24h动态血压,并计算动态脉压(平均收缩压-平均舒张压)及动态脉压指数(动态脉压/平均收缩压)。使用彩色多普勒超声检测颈动脉IMT。分析动态脉压指数与颈动脉IMT的相关性。结果:Pearson相关分析发现,颈动脉IMT与年龄(r=0.353)、平均收缩压(r=0.594)、平均舒张压(r=-0.355)、动态脉压(r=0.855)、动态脉压指数(r=0.883)有良好的相关性(P均<0.001)。进一步行多元逐步回归分析显示,颈动脉IMT与动态脉压及动态脉压指数具有显著线性关系(R2=0.789),动态脉压指数的标准回归系数(β=0.621)大于动态脉压的(β=0.284)。结论:动态脉压指数和动态脉压是评价颈动脉血管硬化的良好指标,动态脉压指数的价值更大。
Objective: To investigate the relationship between dynamic pulse pressure and its index and carotid intima-media thickness (IMT) in patients with essential hypertension. Methods: The ambulatory blood pressure was measured in 159 subjects and the dynamic pulse pressure (mean systolic pressure - mean diastolic pressure) and ambulatory pulse pressure index (ambulatory pulse pressure / mean systolic pressure) were calculated. Carotid IMT was detected using color Doppler ultrasound. The correlation between dynamic pulse pressure index and carotid IMT was analyzed. Results: Pearson correlation analysis showed that carotid IMT was positively correlated with age (r = 0.353), mean systolic pressure (r = 0.594), mean diastolic pressure (r = -0.355), ambulatory pulse pressure (r = 0.883) (all P <0.001). Further stepwise multiple regression analysis showed that there was a significant linear relationship between carotid IMT and ambulatory pulse pressure and ambulatory pulse pressure index (R2 = 0.789), and the standard regression coefficient (β = 0.621) of ambulatory pulse pressure index was greater than that of ambulatory pulse pressure = 0.284). Conclusions: Dynamic pulse pressure index and ambulatory pulse pressure are good indexes to evaluate carotid artery sclerosis. Ambulatory pulse pressure index is more valuable.