高龄老年高血压病患者血压昼夜节律异常与左室结构及功能变化相关性研究  

Effect of abnormal blood pressure rhythm in elderly hypertensive patients on the structure and function of left ventricular

作　　者：杨宇[1] 冯德辉[1] 王俊贤[1] 陈恺[1] 

机构地区：[1]广东医学院附属医院老年病科,湛江524001

出　　处：《中国实用医药》2012年第13期18-20,共3页China Practical Medicine

摘　　要：目的探讨高龄老年高血压病患者血压昼夜节律异常对左室结构及功能变化的相关性。方法应用24h动态血压检测仪检测123例年龄≥80岁的高血压病患者的血压水平,根据血压下降率将患者分为非杓型组,杓型组和反勺型组;分别测量3组患者室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVEDD),计算左室质量指数(LVMI)、左室射血分数(LVEF)及E/A,进行对比分析。结果①24h动态血压结果表明高龄老年高血压患者,杓型血压类型占5%(6例),非杓型血压类型占58%(71例),反杓型血压类型占37%(46例)。②心脏功能和结构指标观察,杓型组、非构型组与反杓型组间比较:主动脉根部内径(mm)(22.4±2.45,26.5±4.49,31.3±5.16)、室间隔厚度(mm)(9.4±1.10,10.6±1.13,11.2±2.50,)、左室后壁厚(mm)(9.0±0.91,9.3±1.02,9.7±1.41)、每搏量(ml)(61.1±16.24,55.2±13.21,45.1±17.36)射血分数(%)(58.21±10.13,52.33±9.81,46.26±12.66)、左室质量(g)(182.7±61.02,202.1±44.51,224.5±43.32,)、左室质量指数(g/m2)(101.3±32.62,110.4±25.71,124.1±22.54)各组间具有统计学差异(P<0.05)。结论高龄老年高血压患者,反杓型血压较杓型及非杓型血压使心脏功能和结构受损更为显著;而非杓型血压较杓型血压使心脏功能和结构受损明显。Objective To investigate the effects of dipper, non-dipper and reverse dipper blood pres- sure patterns on the cardiac structure and function in elderly hypertensive patients. Methods 123 elderly hy- pertensive patients over 80 years old were evaluated with echocardiography and ambulatory 24-hour blood pres- sure monitoring. Tissue Doppler-derived systolic and diastolic parameters were compared with dipper group, non- dipper group and reverse dipper group. Results The results of 24-hour ambulatory blood pressure in elderly hypertensive patients show dipper type of blood pressure accounted for 5 % （6 cases）, non-dipper type of blood pressure accounted for 58% （71 cases） and reverse dipper type of blood pressure accounted for 37% （46 ca- ses）. There was a significant difference with dipper, non-dipper and reverse dipper blood pressure pattern groups for aortic diameter （mm） （22.4 ± 2. 45,26. 5 ± 4.49,31.3 ± 5.16 ）, left ventricular septum thickness （nun） （9. 4 ± 1.10,10. 6 ± 1.13,11.2 ~2. 50）, left ventrieular posterior wall thickness （ram） （9. 0 ±0. 9, 9.3 ± 1.02,9.7 ± 1.41 ）, stroke volume （ml） （61.1 ± 16. 24,55.2 ± 13. 21,45.1 ± 17.36）, ejection fraction （%） （58.21±10.13,52.33 ±9.81,46.26±12.66） ,left ventricularmass （g） （182.7 ±61.02,202.1 ± 44. 51,224. 5 ± 43. 32 ） and left ventricular mass index （ g/m2 ） （ 101.3±32. 62, 110. 4± 25. 71,124. 1 ±22. 54）. Conclusion Reverse dipper blood pressure patterns influence more on left ventricular structure and functions than dipper and non-dipper group in elderly hypertensive patients. And compare with dipper blood pressure patterns, non-dipper blood pressure patterns influence more on left ventricular structure and functions in elderly hypertensive patients.

关 键 词：高龄老年高血压 动态血压检测 昼夜节律 左室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病]