评估新发现乳腺癌妇女的动脉僵化程度和每日动脉压力曲线

T. Brodskaya, T. S. Satalkina, B. Geltser, V. N. Kotelnikov
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摘要

研究目的:评估新诊断为乳腺癌(BC)的女性患者的动脉僵化指标及其与 24 小时动态血压监测(ABPM)参数的相关性。材料与方法:对 158 名年龄在 27-64 岁之间、中位年龄为 45.4 岁、化疗前新诊断为 IIA-IIIB 期 BC 的女性患者进行了前瞻性队列研究。第一组包括109名办公室血压(BP)正常或高正常的患者,第二组包括49名既往诊断为1-2期本质性高血压(EH)且心血管风险较低或中等的女性患者。所有患者均接受了间接动脉造影术和 ABPM。结果。根据 ABPM 数据,第一组中有 54 名(49.5%)女性被诊断为 "掩蔽性 "动脉高血压(MAH)。在 MAH 患者中,日平均血压水平和舒张压时间指数均超过 EH 的相应指标,而晨起收缩压的升高幅度明显较低。在接受检查的 EH 患者中,35.4% 的患者脉搏波速度(PWV)增加,17.4% 的患者脉搏波速度呈病态。在 MAH 患者中,分别有 28.5% 和 14.1% 的病例出现了这些变化。几率比表明,在血压正常的妇女中,脉搏波速度增加 >10 m/s 的几率增加了 1.6 倍,而在合并 MAH 和 EH 的情况下,几率分别增加了 2.2 倍和 2.4 倍。EH患者中心收缩压升高>125毫米汞柱和脉搏血压升高>60毫米汞柱的风险最高:结论:在新确诊的中青年女性 BC 患者中,发现了大量的 MAH 和 EH 病例,这就决定了在开始抗肿瘤治疗前评估动脉僵硬度和日常血压状况的必要性。
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Assessment of arterial rigidity and daily profile of arterial pressure in women with newly detected breast cancer
Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM. Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV >10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP >125 mm Hg and pulse BP >60 mm Hg was highest in patients with EH.Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.
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