充血性心力衰竭患者动态血压的变化及意义  

Changes and clinical significance of ambulatory blood pressure monitoring in patients with congestive heart failure

作　　者：申源生[1] 施丽芳[1] 陈妙芳[1] 

机构地区：[1]广东省惠州市中心医院心内科,516001

出　　处：《广东医学》2000年第12期1024-1025,共2页Guangdong Medical Journal

摘　　要：目的　探讨慢性充血性心力衰竭 (CHF)患者 2 4h动态血压的变化及意义。方法　将 5 7例CHF患者按心功能的受损程度 (NYHA分级 )分为A组 (17例 ,心功能Ⅱ级 )、B组 (19例、心功能Ⅲ级 )和C组 (2 1例 ,心功能Ⅳ级 ) ;根据病因的不同 ,分为D组 (16例 ,扩张型心肌病 )和E组 (41例 ,非扩张型心肌病 ) ;全部患者行 2 4h动态血压 (2 4hABP)检查 ,比较A ,B ,C三组及D、C两组之间平均收缩压、夜间平均收缩压下降率 (nsBPR)及 2 4h平均收缩压变异率 (2 4hsBPV)的差异。结果　C组的平均收缩压较A组和B组略低 ,但三组之间差异无显著性 (P >0 0 5 ) ;D组的平均收缩压显著低于E组(P <0 0 5 )。A ,B ,C 3组的nsBPR减弱或消失 ,分别占 5 8 8% ,88 3 %和 95 2 % ,A组与B ,C组两组之间差异有显著性 (P<0 0 5或 <0 0 1)。A ,B ,C 3组的 2 4hsBPV分别为 9 7,8 8和 8 7,A组与B ,C两组之间差异有显著性 (P <0 0 1)。结论　CHF患者的平均收缩压降低 ,血压昼夜节律减弱或消失 ,血压变异率减小 ,这些变化与病情的严重程度密切相关。Objective To study the changes and clinical significance of 24 hour ambulatory blood pressure monitoring (ABPM) in patients with congestive heart failure (CHF).Methods 57 patients with CHF were divided into three gropus: group A( n =17, heart function class Ⅱ), group B( n=19 , heart function class Ⅲ), group C ( n=21 , heart function class Ⅳ). According to different causes, these patients were divided into group D ( n =19, dilated cardiomyopathy) and group E( n =41, non-dilated cardiomyopathy). All patients were monitored by 24 hour ABPM. Mean systolic pressure, night systolic pressure drop rate (nsBPR) and 24 hours mean systolic pressure variability (24 h sBPV) were compared. Results Mean systolic pressure in group C were slightly lower than those group A and group B. But there were not significant differences among group A,B and C ( P >0 05). Mean systolic pressure in group D were significantly lower than that in group E ( P <0 05). The nsBPR in group A, B and C were 58 %, 88 3%, and 95 2%. There were significantly differences in nsBPR between the group A and B or C ( P <0 05 and <0 01). The 24 h sBPV in group A,B and C was 9 7,8 8 and 8 7. There were significantly differences between group A and group B or C( P <0 01).Conclusion Mean systolic pressure with CHF decreases. Day and night rhythms of blood pressure with CHF were reduced or disappeared. 24 h sBPR was reduced. These changes were positively correlated with the degree of CHF.

关 键 词：充血性心力衰竭 动态血压 血压昼夜节律 血压变异性 

分 类 号：R541.61[医药卫生—心血管疾病]