老年男性颈动脉斑块形成与血压关系的研究

目的探讨老年男性颈动脉斑块的形成与血压水平高低、脉压差大小、平均血压值之间的关系。方法以1461例因动脉硬化所致慢性疾病住院的老年男性患者为研究对象，将入选对象通过血管超声检查，根据有无颈动脉斑块分为两组（颈动脉斑块组1012例和无颈动脉斑块组449例），通过24h动态血压监测（ABPM）记录的收缩压（SBP）、舒张压（DBP）的变化，分别计算每个患者的脉压差（PP）、平均动脉压（MBP），并分析这些数据与颈动脉斑块形成的关系。结果颈动脉斑块组患者的年龄明显高于非颈动脉斑块组[（80．5±5．4）岁与（77．3±5．9）岁，t=-4．233，P〈0．01]；颈动脉斑块组和无颈动脉斑块组比较，24h的SBP[（132．2±17．0）mmHg与（127．5±16．0）mmHg，t=-4．893，P〈0．001]、PP[（60．8±13．4）mmHg与（55．9±12．5）mmHg，t=-5．021，P〈0．001]、MBP[（92．6±10．3）mmHg与（91．0±9．9）mmHg，t=-3．987，P〈0．01]明显高于无颈动脉斑块组。颈动脉斑块组的发病率与年龄（OR=1．061，P=0．0001）、心肌梗死（OR=1．896，P=0．0135）、高血压分级（OR=1．177，P=0．0019）、高血脂（OR=1．353，P=0．0335）、心脏收缩功能降低（OR=2．466，P=0．0001）、下肢动脉斑块（OR=5．453，P=0．0001）密切相关。结论在老年男性人群中，颈动脉斑块的形成与SBP升高、PP增大、MBP的升高密切相关，而与舒张压的水平关系不甚明显。

Relationship between carotid artery plaque and blood pressure in elderly men

Objective To investigate the relationship between carotid artery plaque formation and blood pressure（BP） ,pulse pressure （PP）, mean blood pressure （MBP）in elderly men. Methods A total of 1461 elderly men were divided into carotid artery plaque group（ n = 1012 ）and non-carotid artery plaque group（ n = 449） according to vascular ultrasound examination. Systolic blood pressure （SBP） and diastolic blood pressure （DBP） were recorded by 24-hour ambulatory blood pressure monitoring（ ABPM ）, at the same time pulse pressure （PP）and mean arterial blood pressure （MBP）were calculated. The relationship between carotid artery plaque formation and SBP, DBP, PP, MBP were analyzed. Results The age in carotid artery plaque group was significantly higher than that in non-carotid artery plaque group [ （ 80. 5 ± 5.4 ） years old vs （ 77.3 ± 5.9 ） years old,t = -4. 233,P 〈0. 01 ] ;The levels of SBP,PP and MBP in artery plaque group were significantly higher than those in non-carotid artery plaque group [ SBP：（ 132. 2 ± 17.0 ）mm Hg vs （127. 5 ± 16. 0 ）mm Hg, t = - 4.893,P〈0.001;PP：（60.8 ±13.4）mm Hg vs（55.9 ±12.5）mm Hg,t = -5.021,P〈0.001）;MBP： （92. 6 ± 10. 3）mm Hg vs（91.0 ±9. 9）mm Hg,t = -3. 897 ,P 〈0. 01 ]. The incidence of carotid artery plaque was closely related to age （ OR = 1. 061, P = 0. 0001 ）, myocardial infarction （ OR = 1. 896, P = 0. 0135 ）, hypertension grades（ OR = 1. 177, P = 0. 0019 ）, high cholesterol （ OR = 1. 353, P = 0. 0335 ）, reduced systolic function （ OR = 2. 466, P = 0. 0001 ）, lower extremity arterial plaque （ OR = 5.453, P = 0. 0001 ）. Conclusion In elderly men, formation of the carotid artery plaque is closely related to increased SBP, PP and MBP, but independent to DBP.