目的 探讨原发性高血压病患者血清25-羟基维生素D[25 (OH) D]水平与血压变异性(BPV)的相关性,为高血压的临床治疗提供依据.方法 连续性选取2012年6-12月在新疆医科大学第一附属医院住院部就诊的原发性高血压病患者140例,所有患者行24h动态血压监测并测定血清25(OH)D水平,根据血清25 (OH)D水平分为25 (OH)D非缺乏组65例和25 (OH)D缺乏组75例,比较两组患者的血压水平和BPV,并分析25 (OH)D与BPV之间的关系.结果 25 (OH)D缺乏组的诊室收缩压(cSBP)、诊室舒张压(cDBP)、24h收缩压(24 hSBP)、24h舒张压(24hDBP)、日间收缩压(dSBP)、日间舒张压(dDBP)、夜间收缩压(nSBP)、夜间舒张压(nDBP)、24h收缩压标准差(24 hSSD)、24h舒张压标准差(24 hDSD)、日间收缩压标准差(dSSD)、日间舒张压标准差(dDSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)均高于25 (OH)D非缺乏组,差异均有统计学意义(P<0.05).血清25 (OH)D水平与24 hSSD、24hDSD、dSSD、dDSD呈负相关(r值分别为-0.483、-0.320、-0.437、-0.301,P<0.01).多元线性回归分析显示,25 (OH)D对24 hSSD的影响有统计学意义(P<0.01).结论 原发性高血压病患者25 (OH)D的缺乏可引起BPV的增加.
Objective To study the correlation between serum 25 - hydroxyvitamin D [25 (OH) D] levels and blood pressure variability (BPV) to provide the basis for the clinical treatment of hypertension. Methods The patients ( n = 140) with essential hypertension were continuously chosen from the First Affiliated Hospital of Xinjiang Medical University from June 2012 to December 2012 and were divided into 25 (OH) D non - deficient group ( n = 65 ) and 25 (OH) D deficiency group ( n = 75) according to serum 25 (OH) D levels which was obtained by 24 h ambulatory blood pressure monitoring (24 hABPM) and serum 25 (OH) D levels detecting. The blood pressure levels and BPV were compared between the two groups, and the relationship between vitamin D and BPV were analyzed. Results The clinic systolic blood pressure ( cSBP), clinic diastolic blood pressure (cDBP), 24 h systolic blood pressure (24 hSBP), 24 h diastolic blood pressure (24 hDBP), daytime systolic blood pressure (dSBP), daytime diastolic blood pressure (dDBP), nighttime systolic blood pressure (nSBP), nighttime diastolic blood pressure (nDBP), 24 h systolic blood pressure variability (24 hSSD) , 24 h diastolic blood pressure variability (24 hDSD ), daytime systolic blood pressure variability (dSSD), daytime diastolic blood pressure variability (dDSD), nighttime systolic blood pressure variability (nSSD) and nighttime diastolic blood pressure variability (nDSD) in serum 25 (OH) D deficient group were all higher than those in non -deficient group with significant differences (P 〈 0. 05 ) . Serum 25 (OH) D levels and 24 hSSD, 24 hDSD, dSSD, dDSD were negatively correlated ( r = - 0. 483, - 0. 320, - 0. 437, - 0. 301, P 〈 0. 01 ). Multiple linear regression analysis showed that 25 (OH) D was the factor for 24 hSSD (P 〈 0.01 ) . Conclusion The lack of 25 (OH) D may cause an increase of the BPV in patients with essential hypertension.