本文關(guān)鍵詞： 內(nèi)皮功能 動態(tài)血壓 血壓變異性　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討原發(fā)性高血壓患者血流介導(dǎo)的血管舒張功能與血壓變異性的相關(guān)性。方法:納入2015-2016年山西醫(yī)科大學(xué)第一臨床附屬醫(yī)院高血壓病房的原發(fā)性高血壓患者113例,收集年齡、性別、身高、體重、高血壓病史、服用藥物、心率等一般情況,計算體重指數(shù)(BMI),全部患者需留取清晨空腹靜脈血完善常規(guī)化驗(yàn)檢查,利用UNEX EF 38G血管內(nèi)皮功能檢測儀測量血流介導(dǎo)的血管舒張功能(flow-mediated vasodilation,FMD),利用美國偉倫動態(tài)血壓儀進(jìn)行24h動態(tài)血壓監(jiān)測(ambulatory blood pressure monitoring,ABPM)檢查,通過24h ABPM收集的數(shù)據(jù)計算血壓變異性(blood pressure variability,BPV)參數(shù)[標(biāo)準(zhǔn)差(standard deviation,SD)、變異系數(shù)(coefficient of variance,CV)、加權(quán)標(biāo)準(zhǔn)差(weighted standard deviation,wSD)、平均實(shí)際變異(the average real variability,ARV)]。根據(jù)FMD將患者分為FMD正常組(FMD≥6%)和FMD異常組(FMD6%)。采用單因素和多因素線性分析探討FMD與各因素的相關(guān)性。結(jié)果:納入的113名患者包括男性50例,女性63例,平均年齡(57.98±14.98)歲。1.根據(jù)FMD分組:FMD異常組的收縮壓ARV、收縮壓wSD、夜間收縮壓SD高于正常組[(11.53±2.85)比(10.07±2.02)mm Hg,(12.48±3.31)比(10.79±2.11)mm Hg,(11.45±4.64)比(8.85±2.00)mm Hg](均P0.05)。2.相關(guān)性分析:FMD和年齡、BMI、同型半胱氨酸、收縮壓平均水平及收縮壓ARV、收縮壓wSD、收縮壓SD、白天收縮壓SD、夜間收縮壓SD、收縮壓CV、白天收縮壓CV、夜間收縮壓CV明顯相關(guān)(r=-0.328,-0.251,-0.223,-0.226,-0.322,-0.364,-0.329,-0.332,-0.318,-0.276,-0.253,-0.234,均P0.05)。3.多元線性回歸分析:FMD與收縮壓ARV(β=-0.386,P=0.001)、收縮壓wSD(β=-0.404,P0.001)、收縮壓SD(β=-0.341,P=0.002)、收縮壓CV(β=-0.240,P=0.029)相關(guān)。結(jié)論:原發(fā)性高血壓患者血流介導(dǎo)的血管舒張功能與收縮壓變異性獨(dú)立相關(guān)。
[Abstract]:Objective: to investigate the correlation between blood flow mediated vasodilation function and blood pressure variability in patients with essential hypertension. Methods: 113 patients with essential hypertension were enrolled in the hypertension ward of the first affiliated Hospital of Shanxi Medical University from 2015 to 2016. Collecting age, sex, height, weight, history of hypertension, taking drugs, heart rate, and so on, and calculating body mass index (BMI). All patients need to take fasting venous blood in the morning to complete routine laboratory examination. Vascular endothelium function was measured by UNEX EF38G vascular endothelial function detector. Blood flow mediated vasodilation was measured by flow flow-mediated vasodilation.Ambulatory blood pressure monitoring (ABPM) was performed with the US Viron ambulatory blood pressure meter. The parameters of blood pressure variability (ABPM) were calculated by 24 h ABPM data. The patients were divided into FMD normal group (FMD 鈮，

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