高血压患者昼夜血压节律与无症状性心肌缺血的相关性研究  

Circadian rhythm of blood pressure and silent myocardial ischemia in essential hypertension patients

作　　者：郑智非[1] 陈杰[1] 莫小雄[1] 魏文琦[1] 周志超[1] 

机构地区：[1]广东省湛江中心人民医院心内科,广东湛江524037

出　　处：《安徽医药》2015年第4期732-734,共3页Anhui Medical and Pharmaceutical Journal

基　　金：湛江市科学技术局(No 2010C3102014)

摘　　要：目的：研究高血压患者昼夜血压节律与无症状性心肌缺血的相关性。方法选取2012年3月—2014年3月就诊的164例原发性高血压患者为研究对象，采用问卷调查和临床检查的方式收集患者的信息，通过单因素分析和Logistic回归分析患者昼夜血压节律与无症状性心肌缺血的关系。结果在调整了年龄、文化水平、婚姻状况、吸烟状况、饮酒状况、体质指数（ BMI）、收缩压水平、舒张压水平以及血糖水平等因素后，二元Logistic回归分析结果显示相比于杓型的患者，昼夜节律为反杓型、非杓型和超杓型的患者患有心肌缺血的风险都明显升高，其OR值和95％CI分别为1．38（1．15-1．61）、1．24（1．09-1．39）和1．57（1．36-1．78）。结论对于原发性高血压病的患者，预防并发心肌缺血的关键除控制血压外，还应重视血压昼夜节律是否异常。Objective To analyze the relationship between circadian rhythm of blood pressure and silent myocardial ischemia in essential hypertension patients.Methods A total 420 essential hypertension patients from March 2012 to March 2014 in our hospital were recrui-ted in the study.Quality-of-life questionnaire and clinical examination were used to collect the information of patients.Univariate analysis and multiple linear regression analysis were used to investigate the relationship between circadian rhythm of blood pressure and silent myo-cardial ischemia in hypertensive patients.Results After adjusting for the confounding effects of age,educational level,marital status, smoking status,alcohol consumption status,BMI,systolic blood pressure,diastolic blood pressure and blood sugar levels,the logistic re-gression results showed that patients with reverse-dippers,non-dippers and over-dippers blood pressure rhythm had greater risk for hav-ing silent myocardial ischemia compared with those with dippers blood pressure rhythm,and the OR and 95%CI were 1.38（1.15-1.61）,1.24（1.09-1.39） and 1.57（1.36-1.78）,respectively.Conclusions For patients with essential hypertension,the key to prevention of myocardial ischemia was examine the blood pressure rhythm abnormalities in addition to the concurrent control blood pressure.

关 键 词：原发性高血压 昼夜血压节律 心肌缺血 

分 类 号：R544.1[医药卫生—心血管疾病]