老年高血压患者血压昼夜曲线对靶器官的影响  

Effect of Circadian Rhythm of Blood Pressure on Target Organ Function in Elderly Hypertension Patients

作　　者：李瑛[1] 刘钦铭[1] 叶辉[1] 刘莉[1] 刘鹏鹰[1] 

机构地区：[1]广东省深圳市第二人民医院

出　　处：《中西医结合心脑血管病杂志》2008年第9期1031-1033,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的研究老年高血压患者血压昼夜波动曲线对心、脑、肾靶器官损害的影响。方法根据动态血压监测结果,将患者按血压昼夜曲线分为杓型曲线组(96例)与非杓型曲线组(91例)。应用活动平板试验、超声心动图、CT/磁共振成像(MRI)、眼底检查、血肌酐及尿蛋白等指标,判断心、脑、肾靶器官损害情况。结果非杓型曲线组与杓型曲线组者对比,舒张期室间隔厚度(IVS)及左室后壁厚度(LVPW)增加,舒张早期血流与心房收缩期血流比值(E/A)减小,左室射血分数(LVEF)及左室短轴缩短率(FS)降低,活动平板阳性率增加,脑梗死及腔隙性梗死增多,高血压眼底视网膜病变增多且严重,尿β2微球蛋白(β2MG)及尿白蛋白(ALB)增加(P<0.05或P<0.01)。结论动态血压杓型曲线消失是导致老年高血压患者心、脑、肾靶器官损害的独立危险因子。Objective To assess the effect of circadian rhythm of blood pressure on the target organs function in elderly patients （pts） with hypertension. Methods Based on the results of ambulatory blood pressure monitoring, the pts were divided into ＂dipper＂ group （n 96） and ＂nondipper＂ group （n=91）. The parameters of treadmill test, ultrasonic cardiogram, computerized tomographic scanning/magnetic resonance imaging （MRI）, serum creatinine and urine protein were used to evaluate the function of target organs, such as heart, brain and kidney. Results In the ＂nondipper＂ group, the thickness of interventricular septum （IVS）and posterior wall of left ventricle were increased, early diastolic flow/ atrial systole period flow ratio was decreased. Left ventricular ejection fraction, fraction shortening was decreased in ＂nondipper＂ group. The positive rate of treadmill test was increased; cerebral infarction and la cunar infarction were more observed in ＂ nondipper ＂ group . Retinopathy of hypertension was more and serious . Urinary levels of β2 - microglobulin and urinary albumin were increased in ＂nondipper＂ group（P〈0. 05 or P〈0. 01）. Conclusion The disappearance of circadian rhythm of blood pressure was an independent risk factor to predict the damage of the target organs in elderly pts with primary hypertension.

关 键 词：高血压 血压昼夜曲线 靶器官 

分 类 号：R544.1[医药卫生—心血管疾病] R255.3[医药卫生—内科学]