老老年高血压伴慢性心衰患者心功能分级与动态血压参数相关性研究  

Correlation of different classification of heart function and parameters of ambulatory monitor of blood pressure in very elderly hypertensive patients combined with chronic heart failure

作　　者：魏艺[1] 胡元会[1] 杨传华[2] 宋庆桥[1] 耿彦婷[1] 郑昭瀛[1] 

机构地区：[1]中国中医科学院广安门医院心内科,北京市100053 [2]山东中医药大学第一附属医院心内科

出　　处：《中国心血管病研究》2015年第6期497-501,共5页Chinese Journal of Cardiovascular Research

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项课题（项目编号：JDZX2012109）

摘　　要：目的 研究老老年原发性高血压伴慢性心力衰竭患者心功能分级与动态血压参数之间的相关性.方法 选取2013年5月至2014年4月广安门医院心内科住院的老老年高血压患者147例,根据纽约心功能分级标准将患者分成心功能Ⅰ级48例、Ⅱ级31例、Ⅲ级38例、Ⅳ级30例,比较各组间动态血压参数的数值,并进行相关性分析.结果 不同心功能分级各组间行Spearman相关性分析显示,心功能分级与全天收缩压（r=-0.253,P=-0.004）、全天舒张压（r=-0.247,P=0.005）、白天收缩压（r=-0.309,P=-0.000）、白天舒张压（r=-0.293,P=0.001）、白天脉压（r=-0.179,P=0.044）、全天平均动脉压（r=-0.282,P=0.001）、白天平均动脉压（r=-0.309,P=0.000）、夜间收缩压下降率（r=-0.375,P=0.000）、24h收缩压负荷（r=-0.262,P=0.003）、24h舒张压负荷（r=-0.275,P=0.002）、白天收缩压负荷（r=-0.246,P=0.005）、白天舒张压负荷（r=-0.275,P=0.002）、夜间舒张压负荷（r=-0.229,P=0.01）均呈负相关（P均＜0.05）,差异有统计学意义.经多元线性回归分析显示,白天平均收缩压、夜间平均收缩压为老老年高血压伴随慢性心力衰竭患者的最终影响因素.结论 老老年原发性高血压伴慢性心衰患者心功能与动态血压关系密切,尤其是白天、夜间平均收缩压,故应密切观察患者的动态血压参数,并进行合理的临床干预,有利于患者心功能的改善,预防心功能的进一步恶化,改善老老年高血压患者的生活质量及预后.Objective To study the old aged patients with primary hypertension patients with chronic heart failure, the correlation between heart function classification and ambulatory blood pressure parameters. Methods Select 147 cases of old aged hospitalized in the Department of Cardiology, Guang＇ anmen hospital in 2013 May to 2014 April in hypertensive patients, according to the New York heart functional grade standard divid- ed the patients into the heart function grade： 48 eases of Ⅰ , 31 cases of grade Ⅱ , 38 cases of Ⅲ , 30 eases of grade IV, numerical comparison between each group of ambulatory blood pressure parameters, and correlation analysis. Results The concentric line Spearman correlation function classification between groups analysis showed that cardiac function classification and day systolic blood pressure （r=-0.253, P=0.004）, 24 h diastolic blood pressure （r=-0.247, P=0.005）, daytime systolic blood pressure （r=-0.309, P=0.000）, daytime diastolic blood pressure （r=-0.293, P=0.001）, daytime pulse pressure （r=-0.179, P=0.044）, the average day arterial pressure （r=-0.282, P=0.001 ）, daytime mean arterial pressure （r=-0.309, P=0.000）, nocturnal systolic blood pressure decreased rate（r=-0.375, P=0.000）, 24 hour systolic blood pressure load（r=-0.262, P=0.003）, 24 hours of di- astolic blood pressure load （r=-0.275, P=0.002）, daytime systolic blood pressure load （r=-0.246, P=0.005）, daytime diastolic pressure load （r=-0.275, P=0.002）, nocturnal diastolic blood pressure load （r=-0.229, P= 0.01 ） showed a negative correlation（P〈0.05 ）, there was statistical significance. Multivariate linear regression anal- ysis showed that the mean systolic pressure during the day, night average systolic blood pressure was associated with factors that ultimately influence in patients with chronic heart failure in old aged hypertension. Conclusion In elderly essential hypertensive patients with chronic heart failure, heart function and dynamic blood pressure closely

关 键 词：高血压 老老年 慢性心力衰竭 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]