高血压病患者左心室肥厚与血压负荷值及血压昼夜节律的关系  

Relationship between left ventricular hypertrophy and blood pressure load and circadian rhythm in hypertension

作　　者：王锐[1] 黄佐[2] 赵君[2] 

机构地区：[1]解放军第102医院内科,江苏常州213003 [2]第二军医大学附属长征医院心血管内科,上海200003

出　　处：《医学研究生学报》2005年第B05期54-56,共3页Journal of Medical Postgraduates

摘　　要：目的:探讨高血压病患者左心室肥厚(LVH)与血压负荷及血压昼夜节律的关系。方法:60例高血压病患者经24 h动态血压监测(ABPM)来观察血压负荷值及血压昼夜节律,根据彩色多普勤超声心动图检测结果计算左心室重量指数(LVMI)并判断是否存在LVH。结果:高血压伴LVH者日间、夜间及24 h收缩压(SBP)负荷职显高于非LVH者(88.4±11.6)vs(79.8±13.4),P<0,05;(85.3±12.5)vs(75.4±11.4),P<0.01及(87.4±13.8)vs(78.4±14.4),P<0.05],其血压昼夜节律减弱或消失的检出率达58.8%(10/17),明显高于后者(18.6%,8/43,P<0.005,X2=9.38)。高血压病患者LVMI与日间、夜间及24 h SBP、舒张压(DBP)负荷呈正相关,其中与SBP负荷的相关性又高于。DBP,而与夜间SBP、DBP下降百分率呈负相关。结论:高血压伴LVH 者日间、夜间及24 h SBP负荷值明显上升,其血压昼夜节律减弱或消失检出率明显高于非LVH者。提示高血压LVH与血压负荷及昼夜节律密切相关。Objective: To investigate the association between the left ventricular hypertrophy (LVH) and blood pressure load (BPL) and circadian rhythm in hypertensive patients. Methods:Sixty patients with hypertension were studied by 24-hour ambulatory blood pressure monitoring ( ABPM) and colour Doppler echocardiography. Results: Daytime、 nighttime and 24-hour systolic blood pressure load (d-SBPL、n-SBPL、24h-SBPL) in hypertensive patients with LVH were significantly higher than those without LVH[(88.4±11.6) vs (79. 8±13. 4) ,P <0. 05; (85. 3±12. 5) vs (75. 4±11. 4) ,P < 0.01 and ( 87. 4±13. 8 ) vs ( 78. 4±14. 4) , P < 0. 05 , respectively ]. The incidence of circadian rhythm decreased or losed had reached 58. 8% in LVH group, and was significantly higher than that in non-LVH group( P <0. 005 ) . Left ventricular mass index ( LVMI) in hypertensive patients were signifi cantly correlated positively with the daytime, nighttime and 24-hour systolic and diastolic blood pressure load,and which of systolic blood pressure load was higher than diastolic blood pressure load. However, there was negatively correlations between LVMI and the decreased percentage of n-SBPL、n-DBPL. Conclusion:The d-SBPL、n-SBPL and 24 h-SBPL were significantly increased in hypertensive patients with LVH, and the incidence of circadian rhythm decreased or losed was significantly higher than that in non-LVH group. These findings suggest that LVH was strongly correlated with the blood pressure load and circadian rhythm in hypertension.

关 键 词：高血压 左心室肥厚 昼夜节律 血压负荷 

分 类 号：R544.1[医药卫生—心血管疾病]