左室肥厚与单纯收缩、舒张或双期血压增高的关系  

Relationship of Isolated Systolic, Isolated Diastolic or two phase Hypertension with Left Ventricular Hypertrophy

作　　者：徐泽昌[1] 高瑞娟[1] 张桂珍[1] 田军[1] 黄九延[1] 李鲁光[1] 

机构地区：[1]北京军区总医院心内科

出　　处：《高血压杂志》1998年第4期270-272,共3页Chinese Journal of Hypertension

摘　　要：目的研究高血压病患者单纯收缩期（ＩＳＨ）、单纯舒张期（ＩＤＨ）或双相高血压（ＴＨ）上左室肥厚的关系。方法根据２４小时动态血压将病人分为４组：１．对照组（ｎ＝２７）平均收缩压＜１４０ｍｍＨｇ，平均舒张压＜９０ｍｍＨｇ；２．ＩＳＨ组（ｎ＝１６）平均收缩压＞１４０ｍｍＨｇ，平均舒张压＜９０ｍｍＨｇ；３．ＩＤＨ组（ｎ＝３１）平均收缩压＜１４０ｍｍＨｇ，平均舒张＞９０ｍｍＨｇ；４．ＴＨ组（ｎ＝１９）平均收缩压＞１４０ｍｍＨｇ和平均舒张压＞９０ｍｍＨｇ。超声心动图检测或计算舒张末期左室内径（ＥＤＤ）、室间隔及左室后壁厚度（ＬＶＳＴ，ＬＶＰＷＴ）、左室重量指数（ＬＶＭＩ）。结果ＩＳＨ、ＩＤＨ及ＴＨ组ＬＶＭＩ明显大于对照组Ｐ＜０．００１。ＩＳＨ和ＩＤＨ间、ＩＤＨ和ＴＨ组间无明显统计学差异。结论２４小时动态血压监测诊断为高血压病的患者ＬＶＭＩ明显大于偶测血压增高者。双期血压均高者左室肥厚最重。Aim\ To investigate the relationship of isolated systolic (ISH), isolated diastolic (IDH) or both systolic and diastolic hypertension (TH) to left ventricular hypertrophy in essential hypertension.\ Methods\ Patients were divided in to 4 groups according to 24 hour ambulatory blood pressure monitoring (ABPM). 1. Control group ( n =27): white coat hypertension, Mean systolic blood pressure (MSBP)<140 mmHg, and mean diastolic blood pressure(MDBP)<90 mmHg. 2. Group ISH ( n =16): MSBP>160 mmHg and MDBP<90 mmHg. 3. Group IDH ( n =31): MSBP<140 mmHg and MDBP>90 mmHg. 4. Group two phase hypertension(TH) ( n =19),SBP>140 mmHg and DBP>90 mmHg. Left ventricular internal diameter at end diastole (EDD), thickness of interventricular septum (IVST), posterior wall (PWT) and left ventricular mass index (LVMI) were measured by echocardiography.\ Results\ LVMI in groups ISH, IDH and TH was markedly higher than that of control group (P<0.001). No significant difference of LVMI was found between groups ISH and IDH,but is more prominent in TH group.\ Conclusion\ Patients with essential hypertension identified with 24 hour ABPM had higher LVMI than subjects of white coat hypertension. Patients with two phase hypertension had the most severe ventricular hypertrophy.

关 键 词：动态血压监测 高血压 左心室肥厚 治疗 

分 类 号：R544.105[医药卫生—心血管疾病]