实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (5): 497-501.doi: 10.3969/j.issn.1003-9198.2025.05.013

• 临床研究 • 上一篇    下一篇

血浆降钙素基因相关肽水平预测老年原发性高血压病人血压晨峰现象的价值

黄缘洁, 华东旭, 孙静娴, 顾明霞, 孙伟, 王岚   

  1. 210029 江苏省南京市,南京医科大学第一附属医院(江苏省人民医院)心血管内科(黄缘洁,华东旭,孙伟); 210024 江苏省南京市,江苏省老年病医院(南京医科大学附属老年医院)心血管内科(孙静娴,王岚); 210018 江苏省南京市,南京市中心医院(南京市市级机关医院)心血管内科(顾明霞)
  • 收稿日期:2024-08-30 出版日期:2025-05-20 发布日期:2025-05-20
  • 通讯作者: 王岚,Email:wanglan04@126.com
  • 基金资助:
    江苏省卫生健康委员会老年健康科研课题(LKZ2022006)

Predictive value of plasma calcitonin gene-related peptide level for morning blood pressure surge in elderly patients with primary hypertension

HUANG Yuanjie, HUA Dongxu, SUN Jingxian, GU Mingxia, SUN Wei, WANG Lan   

  1. Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China(HUANG Yuanjie,HUA Dongxu,SUN Wei); Department of Cardiology,Jiangsu Province Geriatric Hospital,Nanjing 210024,China(SUN Jingxian,WANG Lan); Department of Cardiology,Nanjing Central Hospital,Nanjing 210018,China(GU Mingxia)
  • Received:2024-08-30 Online:2025-05-20 Published:2025-05-20
  • Contact: WANG Lan,Email:wanglan04@126.com

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摘要： 目的 探讨老年原发性高血压病人后血浆降钙素基因相关肽(CGRP)水平预测临床用药后血压晨峰(MBPS)现象的价值。 方法 纳入112例老年原发性高血压住院病人,根据临床用药后24 h动态血压监测数据将病人分为非晨峰组(MBPS＜35 mmHg,53例)及晨峰组(MBPS≥35 mmHg,59例),另纳入14例血压正常的老年人作为对照组。收集各项临床数据,测定并比较3组间血浆CGRP水平的差异。采用二元logistic回归分析老年原发性高血压病人临床用药后晨峰高血压的相关因素,并绘制ROC曲线分析血浆CGRP水平对晨峰高血压的预测价值。 结果 晨峰组血浆CGRP水平、诊室SBP、24 h平均收缩压(24hSBP)、白昼平均收缩压(dSBP)、晨起SBP、晨起DBP显著高于对照组及非晨峰组(P＜0.05),晨峰组糖尿病患病率显著高于非晨峰组(P＜0.05)。二元logistic回归分析表明,CGRP、晨起SBP、24hSBP是老年原发性高血压病人临床用药后晨峰高血压的独立影响因素(P＜0.05)。ROC曲线分析显示,CGRP联合晨起SBP、24hSBP预测老年原发性高血压病人临床用药后晨峰高血压的AUC为0.819,其中CGRP的截断值为89.52 pg/mL。 结论 血浆CGRP水平联合晨起SBP、24hSBP可预测老年原发性高血压病人临床用药后晨峰高血压的发生。

关键词: 老年人, 原发性高血压, 降钙素基因相关肽, 血压晨峰

Abstract: Objective To investigate the value of plasma calcitonin gene-related peptide (CGRP) for predicting morning blood pressure surge (MBPS) after medication in the elderly patients with primary hypertension. Methods A total of 112 elderly hospitalized patients with primary hypertension were enrolled in this study.According to the 24 h ambulatory blood pressure monitoring (ABPM) results after medication, the patients were divided into non-morning peak group (MBPS＜35 mmHg, 53 cases) and morning peak group (MBPS≥35 mmHg, 59 cases). In addition, 14 elderly patients with normal blood pressure were enrolled as control group. The clinical data were collected, and the plasma level of CGRP was detected and compared among the three groups. The related factors of MBPS≥35 mmHg after clinical medication in the elderly patients with primary hypertension were analyzed by binary logistic regression, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of plasma CGRP for MBPS≥35 mmHg. Results The levels of CGRP, clinic systolic blood pressure (SBP), 24-hour SBP (24hSBP), daytime SBP (dSBP), morning SBP and morning diastolic blood pressure (DBP) in morning peak group were significantly higher than those in control group and non-morning peak group (P＜0.05). And the prevalence of diabetes in morning peak group was significantly higher than that in non-morning peak group (P＜0.05). Binary logistic regression analysis showed that CGRP, morning SBP and 24hSBP were the independent influencing factors for MBPS≥35 mmHg after clinical medication in the elderly patients with primary hypertension (P＜0.05). ROC curve analysis showed that the area under the curve of CGRP combined with morning SBP, and 24hSBP for predicting MBPS≥35 mmHg after clinical medication in the elderly patients with primary hypertension was 0.819, and the cut-off value of CGRP was 89.52 pg/mL. Conclusions Plasma CGRP combined with morning SBP and 24hSBP can predict the occurrence of MBPS≥35 mmHg after clinical medication in the elderly patients with primary hypertension.

Key words: aged, primary hypertension, calcitonin gene-related peptide, morning blood pressure surge

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