114高血压杂志2006年2月第14卷第2期ChinJHypertension,Feb2006,Vol.14No2论著老老年高血压患者动态血压与靶器官损害的相关性路方红,刘振东,赵颖馨,孙尚文,金世宽,刘军摘要!目的观察研究80以上老老年高血压病患者血压与靶器官损害之间的关系。方法依据WHO/ISH高血压诊断标准和年龄,将296例受试者分为3组,即老年高血压组(∀组)90例,平均年龄687岁;老老年高血压组(#组)116例,平均年龄841岁;与老老年正常血压组(∃组)90例,平均年龄847岁。所有受试者均测24h动态血压;进行心脏及颈动脉超声检查,计算出左室重量与左室重量指数以及颈动脉管壁内膜情况及有无斑块形成;检测尿肌酐及尿白蛋白。结果老老年高血压患者左心室重量指数分别为:(1596%449、1382%325、1381%351)g/m2,与老老年正常血压者、老年高血压患者比较有显著性差异,P<001。老老年高血压患者颈动脉斑块发生率与老老年正常血压者、老年高血压患者比较有显著性差异,分别为:940%、767%、711%,P<005。LVM、LVMI与24hSBP、dSBP、nSBP、nDBP、dPP和nPP显著相关。LogACR(尿白蛋白/尿肌酐比值)与动态血压各参数均相关。结论老老年高血压病患者SBP、SBPL、PP和MAP与靶器官损害有显著相关性。关键词!高血压;老老年;动态血压;靶器官损害RelationshipBetweenAmbulatoryBloodpressureandTargetorganDamageinVeryElderlyHypertensionLUFanghong,LIUZhendong,ZHAOYingxin,SUNShangwen,JINShiguan,LIUJun.DepartmentofCardiovascularDisease,InstituteofBasicMedicine,ShandongAcademyofMedicalScience,Jinan250200,ChinaAbstract!ObjectiveTostudytheassociationbetweenhypertensionandtargetorgandamageinveryelderlypeople.MethodsTwohundredninetysixpatientswithhypertensionwerecategorizedas:elderlyhypertensiongroup(n=90,meanage687years),veryelderlyhypertensiongroup(n=116,meanage841years)andveryelderlynormotensiongroup(n=90,meanage847years).Allsubjectswereunderwentechocardiographicmeasurementofleftventricularmassindex(LVMI),carotidarteryintimamediumthickness,laboratorymeasurementsofurinarycreatinineandurinaryalbuminand24hourambulatorybloodpressuremonitoring(ABPM).ResultsLVMIwassignificantlygreaterinveryelderlyhypertensivesubjects,1596%449vs1382%325g/m2inveryelderlynormotensivesubjectsand1381%351g/m2inelderlyhypertensivesubjects,P<001.Theincidenceofcarotidarteryplaquewas:veryelderlyhypertensivesubjects9397%;veryelderlynormotensivesubjects(707%)andelderlyhypertensivesubjects(711%),P<005.UrinaryACRwasgreaterinveryelderlyhypertensivethaninveryelderlynormotensivesubjects(logACR,122%052vs094%024,P<005).ParametersofABPM(dSBP,dDBP,dMA