心力衰竭患者的血压节律变化  

Circadian blood pressure rhythm in patients with heart failure

作　　者：邰胜[1] 刘志华[2] 

机构地区：[1]苏州大学附属第一医院老年医学科,215006 [2]苏州大学附属第一医院心内科,215006

出　　处：《中华老年心脑血管病杂志》2012年第6期600-602,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察心力衰竭(心衰)患者的血压节律变化。方法选择心衰患者104例(心衰组),行24 h动态血压监测。分别按基础心脏病病因和纽约心脏病协会心功能(NYHA)分级,心功能Ⅱ级34例,Ⅲ级35例,Ⅳ级35例。同期选择门诊及住院的有基础心脏病但无心衰患者82例作为对照组。观察心衰患者血压的昼夜节律变化。结果心衰组血压昼夜节律存在18例(17.3%),昼夜节律消失86例(82.7%),其中节律倒置38例(44.2%);对照组血压昼夜节律存在43例(52.4%),昼夜节律消失39例(47.6%),其中血压昼夜节律倒置10例(25.6%)。心衰组血压昼夜节律消失发生率明显高于对照组(P<0.05)。心衰组心功能Ⅱ级患者血压昼夜节律消失明显低于Ⅲ级、Ⅳ级患者(70.6%vs 85.7%vs 91.4%,P<0.05)。结论心衰患者血压昼夜节律消失明显升高,且随着心功能分级增加而增加,但与心脏病病因无关。Objective To observe the circadian blood pressure rhythm in patients with heart failure （HF）. Methods Dynamic blood pressure was monitored in 104 HF patients（as a HF group） for 24 h. The cardiac function was classified as II , II and IV in 34,35 and 35 patients,respectively,according to the basic etiology of heart disease and the cardiac function classification of New York Heart Association. Eighty-two patients with heart disease but without HF served as a control group and their circadian blood pressure rhythm was recorded. Results Of the 104 patients in HF group,18（17.3%） had a normal circadian blood pressure rhythm and 86（82.7%） had an abnormal circadian blood pressure rhythm including 38（44.2%） with an inverted circadian blood pressure rhythm. Of the 82 patients in control group,43（52.4%） had a normal circadian blood pressure rhythm and 39 （47. 6%） had an abnormal circadian blood pressure rhythm including 10 （25.6%） with an inverted circadian blood pressure rhythm. The incidence of abnormal circadian blood pressure rhythm was significantly higher in HF group than in control group （82. 7% vs 47.6% vs 25.6%）and significantly lower in patients with their cardiac function classified as II than in those with their cardiac function classified as III or IV（70.6% vs 85.7% vs 91.4%,P〈 0.05）. Conclusion The abnormal circadian blood pressure rhythm increases significantly in HF patients, which is positively related with cardiac function but not with the etiology of heart disease.

关 键 词：心力衰竭 血压 昼夜节律 血压监测 便携式 神经分泌系统 

分 类 号：R541.6[医药卫生—心血管疾病]