日间血压变异与高血压患者左心室肥厚的相关性  

Day-by-day blood pressure variability and left ventricular hypertrophy in hypertensive patients

作　　者：曲尧 尹新华[2] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院门诊化疗科,150081 [2]哈尔滨医科大学附属第一医院心内科,150001

出　　处：《国际心血管病杂志》2015年第4期285-287,共3页International Journal of Cardiovascular Disease

基　　金：国家自然科学基金面上项目(81370319)

摘　　要：目的:探讨日间血压变异性(blood pressure variability,BPV)与高血压患者左心室肥厚的相关性。方法:入选2013年11月至2014年1月于心内科及神经内科住院的高血压患者183例,连续监测血压6 d,以收缩压(SBP)值的标准差作为日间BPV的评估指标,将患者分为2组:BPV≥8.62 mmHg组、BPV<8.62 mmHg组,收集患者的临床资料,进一步探讨日间BPV与左心室肥厚的关系。结果:(1)与日间BPV<8.62 mmHg的患者相比,日间BPV≥8.62 mmHg的患者脑卒中患病率、SBP、舒张压、低密度脂蛋白胆固醇水平、尿蛋白阳性率、左心室后壁厚度、左心室质量指数(left ventricular mass index,LVMI)明显增高,低脂饮食的比例、平均睡眠时间较低(P<0.05);(2)多元线性回归分析显示,在校正了多个混杂因素后,日间BPV与LVMI呈正相关。结论:日间BPV高的患者临床状况较差,日间BPV高是左心室肥厚的独立危险因素。Objective： To explore the relationship between day-by-day blood pressure variability （BPV） and left ventricular hypertrophy in hypertensive patients. Methods： A total of 183 hospitalized patients with hypertension were enrolled in this study from Departments of Cardiology and Neurology from November 2013 to January 2014. Standard deviation of systolic blood pressure （SBP） values for six consecutive days was applied as an evaluation of day-by-day BPV. Patients were divided into two groups according to mean BPV： ≥8. 62 mmHg group and 〈8. 62 mmHg group. Clinical information was collected and the relationship between left ventricular hypertrophy and BPV was analyzed. Results： （1） In BPV≥8. 62 mmHg group, prevalence of stroke, the level of SBP, diastolic blood pressure, low density lipoprotein-cholesterol, left ventricular mass index （LVMI）, left ventrieular posterior wall thickness and the positive rate of urinary protein were higher, while the proportion of low-fat diet population and the average sleep time were lower than the other group. （2） Multivariate linear regression analysis showed that LVMI was positively correlated with clay-by-day BPV after adjusting for multiple confounders. Conelusions：The clinical status of the patients with high day-by-day BPV is poor, and high day-by-day BPV is an independent risk factor for left ventricular hypertrophy.

关 键 词：高血压 日间血压变异性 左心室肥厚 左心室质量指数 

分 类 号：R544.1[医药卫生—心血管疾病]