高血压患者运动试验中血压变化与靶器官损伤的关系研究  

Blood Pressure Responses during Exercise Testing and Subclinical Target Organ Damage in Hypertension Patients

作　　者：钱宗杰[1] 李全忠[1] 廖发荣[1] 

机构地区：[1]桂林医学院附属医院心内科,广西桂林市541001

出　　处：《中国全科医学》2013年第5期503-505,共3页Chinese General Practice

基　　金：国家自然科学基金项目(81160489);广西自然科学基金项目(2012GXNSFAA053080)

摘　　要：目的探讨轻中度高血压患者在运动试验中血压变化程度与靶器官损伤的关系。方法选择112例Ⅰ、Ⅱ级高血压患者,根据运动试验中患者血压升高的水平,分为轻度升高组(21例)、中度升高组(48例)和重度升高组(43例)。记录3组患者的临床资料,检测血脂、血同型半胱氨酸、肾小球滤过率、尿微量清蛋白、颈动脉内中膜层厚度(IMT)、左室质量指数(LVMI)。结果重度升高组的年龄、体质指数、静息时心率、女性比例、吸烟率与中度升高组和轻度升高组比较,差异均有统计学意义(P<0.05),且中度升高组与轻度升高组比较,差异均有统计学意义(P<0.05)。3组患者血脂水平和高血压家族史发生率的差异均无统计学意义(P>0.05)。重度升高组的尿微量清蛋白、肾小球率过滤、颈动脉IMT和LVMI与中度升高组和轻度升高组比较,差异均有统计学意义(P<0.05),且中度升高组与轻度升高组比较,差异均有统计学意义(P<0.05)。结论高血压患者运动试验中血压升高程度可提示靶器官损伤。Objective To investigate the correlation of subclinical target organ damage with blood pressure （BP） re- sponse in exercise testing in patients with mild or moderate hypertension. Methods A total of 112 patients with stage Ⅰ or Ⅱ hypertension were divided, according to levels of blood pressure in exercise testing, into groups A （n = 21, BP increased mild- ly）, B （ n = 48, BP increased moderately）, C （ n = 43, BP increased severely）. Clinical data were recorded, and blood fat, homocysteic acid （ Hcy）, glomerular filtration rate （ GFR）, microalbuminuria （ MA）, carotid intima - media thickness （ IMT）, left ventricular mass index （LVMI） determined. Results Group C were different from group B, A in age, body mass index, resting heart rate, percentage of women, smoking rate （ P 〈 0. 05 ）, and group B different from group A （ P 〈 0. 05 ）. But no significant difference was noted in blood fat and incidence of familial hypertension between 3 groups （ P 〉 0. 05 ）. There was sig- nificant difference in MA, GFR, carotid IMT, LVMI between group C and group B （P 〉0. 05）, and between B and A groups （ P 〈 0. 05 ）. Conclusion Blood pressure responses in exercise testing can be used to assess the severity of subclinical target or- gan damage in patients with hypertension.

关 键 词：高血压 运动试验 靶器官 

分 类 号：R544.16[医药卫生—心血管疾病]