老年原发性高血压病患者动态血压变异性对心脏结构和肾功能损伤的临床研究  

Clinical study of the influence of blood pressure variability on cardiac structure and renal injury in patients with senile essential hypertension

作　　者：黄惠琼 周荣才 卢忠 吴燕连 张小萍 郑则明 阳湘文 孙灵华 梁建忠 黎红娟 

机构地区：[1]佛山市禅城区澜石医院内科,528041

出　　处：《国际医药卫生导报》2009年第11期7-10,共4页International Medicine and Health Guidance News

摘　　要：目的观察老年原发性高血压病患者血压变异性（BPV）对心脏结构和肾功能损伤影响。方法根据夜间血压下降率将患者分为年龄、性别相匹配的两组,夜间血压下降率〈10%为非杓型组,≥10%为杓型组。应用24小时动态血压监测和超声心动图方法观察并比较200例原发性高血压病患者的动态血压节律及心脏结构、肾功能的特点。结果非杓型组24h收缩压、24h舒张压、夜间收缩压、夜间舒张压明显高于杓型组,非杓型组夜间血压变异显著高于杓型组,非杓型组左室重量指数高于杓型组,肾功能尿系列蛋白检出率非杓型组均显著高于杓型组。结论非杓型组高血压病人的血压节律类型较杓型组者更易导致左心室肥厚及肾功能减退。Objective To investigate the influence of blood pressure variability （BPV） on cardiac structure and renal injury in patients with senile essential hypertension. Metlaods Two hundred patients with essential hypertension were divided into two groups according to decreasing rate of blood pressure in night. The paitients with 〈 10% decreasing rate of blood pressure were allocated into non-dipper group and ≥ 10% into dipper group, which were matched in age and gender. Ambulatory blood pressure monitoring and echocardiography were performed in all of them. Results 24 h SBP, 24 h DBP, night SBP （nSBP） and night DBP （nDBP） were significantly higher in non-dipper group than those in dipper group. Night BPV was significantly higher in non-dipper group than those in dipper group. Left ventricular mass index was higher in non-dipper group than those in dipper group. Most of finding rate of a series microproteinuria was significantly higher in non-dipper group than those in dipper group. Concluaions Non-dipper circadian rhythm could induce the decrease of renal function and increase of left ventricular hypertrophy in patients with essential hypertension.

关 键 词：高血压 血压异变 血压监侧 左室肥厚 尿Β2-微球蛋白 24小时尿微量白蛋白 

分 类 号：R544[医药卫生—心血管疾病]