高血压病患者血压变异性及其与左室肥厚的关系  

Blood Pressure Variability in Essential Hypertension and Its Relationship with Left ventricular Hypertrophy

作　　者：卓德华[1] 潘扬[1] 曹宸赟[1] 关敬树[1] 唐丽萍[1] 曹承吉[1] 龚兰生[2] 

机构地区：[1]上海市宝山中心医院心内科,上海宝山201900 [2]上海市瑞金医院,上海市高血压研究所,上海200025

出　　处：《高血压杂志》2002年第1期27-29,共3页Chinese Journal of Hypertension

摘　　要：目的　探讨血压变异性 (L BPV)与高血压性左室肥厚 (LVH)的关系。方法　选择原发性高血压 (EH)患者 93例 (男 4 7例 ,女 4 6例 ,年龄 2 4～ 5 9岁 ,平均 4 7 37± 8 0 3岁 ) ,分为LVH组与无LVH组 ,并与年龄相近的正常血压者4 6例作对照。采用无袖带式BP5 0仪作 2 4小时动态血压监测。以各时间段血压的标准差 (SD)作为血压变异的指标 :2 4小时收缩压变异 (2 4hSSD)和舒张压变异 (2 4hDSD)、白昼收缩压变异 (dSSD)和舒张压变异 (dDSD)、夜间收缩压变异 (nSSD)和舒张压变异 (nDSD)。组间使用t分布的不相等方差检验。超声心动图测定左室重量指数 (LVMI)。结果　 (1)三组均显示收缩压变异度 (SSD)明显大于舒张压变异度 (DSD)。 (2 )与正常对照组比较 ,LVH组与无LVH组患者的 2 4hSSD、dSSD、nSSD均显著增大 (P <0 0 5 ) ,尤其 2 4hSSD与dSSD。 (3)LVH组较无LVH组的 2 4hSSD、dSSD、dDSD、nSSD、nDSD显著增大。结论　EH患者心血管交感、迷走神经功能失衡 ,伴LVH时这种改变更明显。故用动态血压监测EH患者的BPV ,可能与靶器官损害程度有关。Aim To investigate the relationship between the blood pressure variability (BPV) and left ventricular hypertrophy (LVH) in patients with essential hypertensive (EH) using 24 hour BP50 ambulatory blood pressure monitoring(ABPM) device. Methods Ninety three EH patients with and without LVH (47 males, 46 females, mean age 47.37±8 03 years) matched in sex and age, and compared with age matched normotensives(NT) controls( n =46). BPV was measured by the SD mean of systolic and diastolic pressures during 24 hour and circadian: 24 hSSD, 24 hDSD, dSSD, dDSD, nSSD and nDSD. Left ventricular mass index(LVMI) was evaluated by echocardiography. Results (1)The variability of systolic pressure during 24 hour and circadian was significantly higher than that of diastolic pressure in EH and normal controls. (2) 24hSSD,dSSD and nSSD were significantly higher in EH patients than that of normal controls ( P <0 05).(3) In EH patients with LVH, the 24hSSD, dSSD, dDSD, nSSD and nDSD were significantly higher than that of EH patients without LVH and normal control( P <0 05). Conclusion This investigation suggests that the cardiovascular sympathovagal balance was impaired in EH patients, which is more significant in the EH patients with LVH than those without. Therefore, the BPV of EH patients may be associated with the severity of the degree of target organ damage.

关 键 词：原发性高血压 左室肥厚 血压变异性 EH 超声心动图 病理机制 靶器官损害 

分 类 号：R544.1[医药卫生—心血管疾病] R541.9[医药卫生—内科学]