中年高血压患者血压晨冲现象与靶器官损害关系探讨  

Relationship Between Morning Blood Pressure Surge and Clinical Target Organ Damage in the Middle - aged Hypertension Patients

作　　者：黄友良[1] 俞群军[1] 谭碧峰[1] 

机构地区：[1]怀化医专附属医院怀化市三医院心内科,湖南怀化418000

出　　处：《怀化医学高等专科学校学报》2009年第1期33-36,共4页

摘　　要：目的探讨中年高血压患者血压晨冲现象（BPMS- blood pressure morning surge）对临床靶器官心脏和肾脏的损害：方法中年高血压患者178例，根据24h动态血压监测结果分为BPMS组（62例）和N—BPMS组（116例）。常规检测：血脂、体重指数、肌酐、空腹血糖、左室质量指数、E／A、EF、SVl＋RV5、尿微量白蛋白。结果BPMS组24h、白昼、夜间平均收缩压和平均舒张压均显著高于N—BPMS组动态血压监测结果（P〈0．05）；BPMS组LVMI136．8±11．4g／m0、E／A0．8±0．18高于N—BPMS组124．9±14．dg／m^2与0．97±0．19（P〈0．05），但两组间EF值相比较无统计学差异（P〉0．05）；BPMS组Sv1＋Rv5（男4．08±0．42mv、女3．72±0．38my）高于N—BPMS组，（男3．25±0．36my、女2．8±0．34mv）（P〈0．05）；另外，BPMS组MAU93．1±26．3mg／24h显著高于N—BPMS组62．7±20．2mg／24h（P〈0．01）：结论中年高血压患者血压晨冲有明显的左心室肥厚、舒张功能不全、早期肾损害，而对收缩功能影响不大。中年高血压晨冲现象表现以收缩压和舒张压均增加，不同于青年高血压以舒张压增高为主，老年高血压以收缩压增高为主：因此，中年高血压患者更应控制好血压及晨冲以保护好靶器官、Objective To investigate the relationship between the target organ damage and morning blood pressure surge in the middle - aged hypertension patients. Methods 178 patients submitted to 24 b ambulatory blood pressure monitoring were categorized into BPMS group （62） and N- BPMS （116） .Their total cholesterol, body mass index （BMI）, left ventricular mass index, electrocardiographic voltage Sv1 ＋ RV5, left ventricular diastolic dysfunction systolic function and microalbunminuria were determine. Results The mean systolic pressure and diastolic pressure during 24 h, days and nights in BPMS group were significantly higher than those in the N - BPMS group （P 〈 0.05） . Compared with the N- BPMS group, the BPMS group was significantly higher （LVMI： BPMS136.8 ±11.4g/m2 VS N - BPMS 124.9 ±14.4g/m2, E/A, SV1 ＋ RVS： BPMS 0.84 ±0.18VS N- BPMS0.97 ±0.19 SV1 ＋ RVS： BPMS： man 4.08± 0.42my VS N- BPMS 3.25 ± 0.36my BPMS： woman 3.72 ± 0.38my VS N - BPMS 2.8 ± 0.34mv （all P 〈 0.05） MAU： BPMS93.1±26.3 rag/24 h VS N- BPMS 42.7＋20.2 rag/24 h （P〈0.01） .Conclusion The middleaged patients with hypertension of BPMS have left ventricular hypertrophy, diastolic dysfunction and the early renal damage, but systolic function was normal. Systolic pressure and diastolic pressure have morning blood pressure surge in the middle - aged, which is different from the elderly people in the major of systolic blood pressure and the young people in the major of diastolic blood pressure. Therefore, the middle - aged with high blood pressure should control morning blood pressure surge to protect target organ.

关 键 词：中年高血压 晨冲现象 靶器官 动态血压监测 心脏超声 

分 类 号：R544.1[医药卫生—心血管疾病]