高血压患者左心室肥厚与昼夜血压变化的性别差异  

Gender difference in left ventricular hypertrophy and circadian changes of blood pressure in hypertensive patients

作　　者：柳淑云[1] 张玉华[2] 尹秀荣[3] 

机构地区：[1]大庆市第四医院心内科,黑龙江省大庆市163712 [2]大庆市第四医院超声科,黑龙江省大庆市163712 [3]中国医科大学

出　　处：《中国临床康复》2005年第19期90-91,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨高血压患者血压昼夜节律变化对左心室肥厚的影响与性别的关系。方法:选择2000-01/2004-06大庆市第四医院心内科住院的原发性高血压病II期患者93例。行24h动态血压监测和超声心动图检查。采用动态血压分析系统自动测压,白昼间隔每15分1次,夜间每30分1次。24h测压78次。统计分析24h、白昼、夜间平均收缩压与舒张压。由计算机处理打印血压明细表,绘制血压曲线图。超声心动图采用美国HP5500型,测量室间隔厚度、左室舒张末期内径、左室后壁厚度。计算左室质量。以左室质量男≥125g/m2,女≥120g/m2诊断为左室肥厚。血压昼夜节律判定采用动态血压正常值协作研究所规定的标准,既夜间血压平均值比日间下降10%以上称之为杓型改变,夜间血压平均值比日间下降<10%称之为非杓型改变。结果:93例均进入结果分析。①昼夜血压呈杓型改变41例,男25例,女16例;非杓型改变52例,男33例,女19例。②杓型与非杓型组相比,偶测血压和白昼平均血压均无显著差异(P>0.05)。女性非杓型组24h平均收缩压比杓型组明显升高犤(154.13±15.23),(135.21±9.71)mmHg,t=2.541,P<0.05犦;夜间平均收缩压明显升高犤(147.36±18.65),(124.49±8.89)mmHg,t=2.812,P<0.05犦;睡眠时最低平均收缩压明显升高犤(130.89±18.78),(109.89±11.57)mmHg,t=3.203,P<0.05犦。而男性高血压患者杓型与非杓型组各血压指标间均无显著性差异(P>0.05)。③女性非杓型组的室间隔厚度与杓型组相比明显增厚犤(1.45±0.42),(1.01±0.12)cm,t=2.421,P<0.05犦;左室后壁厚度明显增厚犤(1.26±0.19),(0.96±0.13)cm,t=2.902,P<0.05犦;左室质量明显增大犤(329.32±95.29),(229.32±27.31)g/m2,t=3.104,P<0.05犦。男性患者非杓型组与杓型组的室间隔厚度、左室后壁厚度、左室质量参数比较均无显著差异(P>0.05)。结论:女性高血压患者昼夜血压非杓型改变较杓形改变者左室肥厚程度显著,而男�AIM:To investigate the effect of the circadian rhythmic changes of blood pressure changes on left ventricular hypertrophy and its correlation with gender in hypertensive patients.METHODS:Ninety three inpatients with primary hypertension at stage Ⅱ ,who were hospitalized in the Department of Cardiology,Daqing Fourth Hospital between January 2000 and June 2004,received 24 hour ambulatory blood pressure monitoring and echocardiography.The blood pressure was measured automatically with the ambulatory blood pressure analytical system,once every 15 minutes during daytime and once every 30 minutes during night,and it was measured for 78 times in 24 hours.The 24 hour,diurnal and nocturnal mean systolic and diastolic pressures were analyzed statistically.The detailed list of blood pressure was dealt and printed,and the blood pressure curve was drawn with computer.The thickness of interventricular septum,left ventricular end diastolic diameter,and thickness of left ventricular posterior wall were measured with the American HP5500 echocardiogram.Left ventricular mass was calculated.Left ventricular hypertrophy was diagnosed by left ventricular mass ≥ 125 g/m2 for males and ≥ 120 g/m2 for females.The circadian rhythm of blood pressure was judged with the standard set by Zhang's association for the normal value of ambulatory blood pressure,that was,nocturnal mean blood pressure reduced by more than 10% as compared with the diurnal one was called dipper change,and nocturnal mean blood pressure reduced by less than 10% as compared with the diurnal one was called non dipper change.RESULTS:All the 93 cases were involved in the analysis of results.① Dipper and non dipper changes:Dipper changes were observed in 41 cases(25 males and 16 females),and non dipper changes were observed in 52 cases(33 males and 19 females).② The occasionally measured blood pressure and diurnal mean blood pressure were insignificantly different between the dipper and non dipper groups(P >0.05).The female 24 hour mean systolic pressure[(154.13±

关 键 词：高血压 左室肥厚 血压 

分 类 号：R544.1[医药卫生—心血管疾病]