红细胞分布宽度与杓型/非杓型高血压状态的相关性分析
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摘要
目的探讨红细胞分布宽度(RDW)与杓型/非杓型高血压状态之间的关系。方法将286名受试者按照血压状态分为3组:对照组70例,均为血压正常者;杓型高血压组(杓型组)102例,白天收缩压在夜间减少程度≥10%者;非杓型高血压组(非杓型组)114例,白天收缩压在夜间减少程度<10%者。动态血压监测仪监测受试者24 h动态血压,收集血液样品测量RDW并通过自动血液学分析系统进行分析,比较3组血压、RDW水平和动态血压参数,分析高血压患者RDW值与夜间血压下降程度之间的相关性。结果杓型组和非杓型组患者的舒张压和收缩压均明显高于对照组,差异有统计学意义(均P<0.05),杓型组和非杓型组间的舒张压和收缩压差异均无统计学意义(均P>0.05);与对照组相比,杓型组和非杓型组患者的RDW值均明显升高,差异有统计学意义(均P<0.05),与杓型组相比,非杓型组的RDW值显著升高,差异有统计学意义(P<0.05);与杓型组相比,非杓型组24 h收缩压、24 h舒张压和24 h动脉压显著升高,差异有统计学意义(均P<0.05),与杓型组相比,非杓型组白天收缩压、白天舒张压、白天动脉压差异无统计学意义(均P>0.05),与杓型组相比,非杓型组的夜间收缩压、夜间舒张压、夜间动脉压显著升高,差异有统计学意义(均P<0.05);非杓型组RDW值与夜间收缩压呈负相关(r=-0.199,P=0.027),非杓型组RDW值与夜间舒张压之间未发现明显相关关系(r=-0.079,P=0.383)。结论与杓型组和对照组相比较,RDW与非杓型组具有更强的相关关系,RDW或可作为非杓型高血压状态的监测指标。
Objective To investigate the relationship between red blood cell distribution width(RDW) and dipper/non-dipper hypertension.Methods A total of 286 subjects were divided into three groups according to nighttime reduction in daytime systolic blood pressure(SBP):control group(normal blood pressure,n=70),dipper group(SBP reduction≥10%,n=102),and non-dipper group(SBP reduction<10%,n=114).The 24 h ambulatory blood pressure was examined,and blood samples were collected for RDW measurement.The blood pressure,RDW and ambulatory blood pressure parameters were compared among the three groups to analyze the correlation between RDW and night-time blood pressure reduction.Results The diastolic and systolic blood pressure in both dipper and non-dipper groups was higher than that in control group(P<0.05),but that in dipper group was not significantly different from that in non-dipper group(P>0.05).The RDW in both dipper and non-dipper groups was larger than that in control group,and that in non-dipper group was larger than that in dipper group(P<0.05).Furthermore,24 h average SBP,24 h average diastolic blood pressure(DBP),24 h mean arterial blood pressure(MBP),average nighttime SBP,average nighttime DBP and average nighttime MBP in non-dipper group were higher than those in dipper group(P<0.05).There were no significant differences in average daytime SBP,DBP and MBP between dipper group and non-dipper group(P>0.05).In non-dipper group,the RDW was negatively correlated with nighttime SBP(r=-0.199,P=0.027),but not related to nighttime DBP(r=-0.079,P=0.383).Conclusion Patients with non-dipper hypertension have larger RDW than dipper hypertensive patients and normal blood pressure subjects,suggesting that RDW can be used as a monitoring index of non-dipper hypertension.
Objective To investigate the relationship between red blood cell distribution width(RDW) and dipper/non-dipper hypertension.Methods A total of 286 subjects were divided into three groups according to nighttime reduction in daytime systolic blood pressure(SBP):control group(normal blood pressure,n=70),dipper group(SBP reduction≥10%,n=102),and non-dipper group(SBP reduction<10%,n=114).The 24 h ambulatory blood pressure was examined,and blood samples were collected for RDW measurement.The blood pressure,RDW and ambulatory blood pressure parameters were compared among the three groups to analyze the correlation between RDW and night-time blood pressure reduction.Results The diastolic and systolic blood pressure in both dipper and non-dipper groups was higher than that in control group(P<0.05),but that in dipper group was not significantly different from that in non-dipper group(P>0.05).The RDW in both dipper and non-dipper groups was larger than that in control group,and that in non-dipper group was larger than that in dipper group(P<0.05).Furthermore,24 h average SBP,24 h average diastolic blood pressure(DBP),24 h mean arterial blood pressure(MBP),average nighttime SBP,average nighttime DBP and average nighttime MBP in non-dipper group were higher than those in dipper group(P<0.05).There were no significant differences in average daytime SBP,DBP and MBP between dipper group and non-dipper group(P>0.05).In non-dipper group,the RDW was negatively correlated with nighttime SBP(r=-0.199,P=0.027),but not related to nighttime DBP(r=-0.079,P=0.383).Conclusion Patients with non-dipper hypertension have larger RDW than dipper hypertensive patients and normal blood pressure subjects,suggesting that RDW can be used as a monitoring index of non-dipper hypertension.
引文
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[11] DE GONZALO CALVO D,DE LUXAN-DELGADO B,RODRIGUEZ GONZALEZ S,et al.Interleukin 6,soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population:a translational approach[J].Cytokine,2012,58(2):193-198.
[2] CUSPIDI C,MICHEV I,MEANI S,et al.Nondipper treated hypertensive patients do not have increased cardiac structural alterations[J].Cardiovasc Ultrasound,2003,17(4) :245-251.
[3] FUKUTA H,OHTE N,MUKAI S,et al.Elevated plasma levels of B-type natriuretic peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease[J].Int Heart J,2009,50(3):301-312.
[4] BIRKENHAGER A M,VAN DEN MEIRACKER A H.Causes and consequences of a non-dipping blood pressure profile[J].Neth J Med ,2007,65(4):127-131.
[5] VASUNTA R L,KESANIEMI Y A,YLITALO A,et al.Nondipping pattern and carotid atherosclerosis in a middle-aged population:OPERA Study[J].Am J Hypertens,2012,25(1):60-66.
[6] FARMER C K,GOLDSMITH D J,QUIN J D,et al.Progression of diabetic nephropathy:is diurnal blood pressure rhythm as important as absolute blood pressure level[J].Nephrol Dial Transplant,1998,13(3):635-639.
[7] IJIRI H,KOHNO I,YIN D,et al.Cardiac arrhythmias and left ventricular hypertrophy in dipper and nondipper patients with essential hypertension[J].Jpn Circ J,2000,64(7):499-504.
[8] VAZDEMELO R O,TOLEDO J C,LOUREIRO A A,et al.Absence of nocturnal dipping is associated with stroke and myocardium infarction[J].Arq Bras Cardiol,2010,94(1):79-85.
[9] WANG Y L,HUA Q,BAI C R,et al.Relationship between red cell distribution width and short-term outcomes in acute coronary syndrome in a Chinese population[J].Intern Med ,2011,50(24):2941-2945.
[10] TONELI M,SACKS F,ARNOLD M,et al.Cholesterol and recurrent events(CARE) trial investigators:relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease[J].Circulation,2008,117(2):163-168.
[11] DE GONZALO CALVO D,DE LUXAN-DELGADO B,RODRIGUEZ GONZALEZ S,et al.Interleukin 6,soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population:a translational approach[J].Cytokine,2012,58(2):193-198.