老年原发性高血压患者心脏舒张功能的评价  

Assessment of heart diastolic function in elderly essential hypertensive patients

作　　者：张添甜[1] 张潇怡[2] 孙光[1] 赵紫薇[1] 礼希曦 林杰[1] 

机构地区：[1]沈阳中国医科大学附属第一医院老年心血管科,沈阳110001 [2]中国医科大学第96期临床医学系

出　　处：《中华老年心脑血管病杂志》2016年第6期586-589,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：辽宁省教育厅高校科研计划(L2010593)

摘　　要：目的观察老年原性发高血压(EH)患者血压水平及昼夜节律,探讨其与左心舒张功能的相关关系。方法选择因冠心病、糖尿病、缺血性脑血管病等在我院老年心血管内科住院的EH患者57例(EH组)。血压正常患者57例(NBP组)。对所有患者行24h动态血压监测、心脏超声及组织多普勒检查,测量二尖瓣舒张早期血流峰速(E)、二尖瓣环舒张早期运动峰值速度(E′),计算E/E′比值。结果 EH组糖尿病、冠心病的发病率明显高于NBP组(P<0.05);行多重线性回归分析显示:年龄、24h平均收缩压(24hSBP)、脉压、24h收缩压负荷(24hSBPL)与E/E′比值呈显著正相关(P<0.01),为E/E′比值的危险因素;24h平均舒张压(24hDBP),24h舒张压负荷(24h DBPL)为E/E′比值的保护性因素(P<0.05,P<0.01)。回归方程为E/E′比值=0.062+2.533×年龄+3.765×24hSBP-2.919×24hDBP+3.75×脉压+3.331×24hSBPL-1.933×24hDBPL。结论老年EH患者心脏舒张功能较显著下降,其收缩压升高、舒张压降低、脉压增加、SBPL增加,均是舒张功能降低的危险因素。Objective To study the relation of blood pressure and cardiac circadian rhythms with left heart diastolic function in elderly essential hypertensive（EH）patients.Methods Fifty-seven elderly EH patients（34males and 23females）aged 50-91（68.88±15.64）years admitted to our hospital due to CHD,DM and ischemic cerebrovascular disease served as an EH group and 57patients（45males and 12females）with normal blood pressure（NBP）aged 52-87（68.79±12.83）years served as a NBP group in this study.The patients underwent 24 hambulatory blood pressure,cardiac and Doppler ultrasonic monitoring.Results The incidence of DM and CHD was significantly higher in EH group than in NBP group（P〈0.05）.Multivariate linear regression analysis showed that age,24 hSBP,PP and 24hBPL-SBP were positively related with E/E′（P〈0.05）and were the risk factors for E/E′while 24 hDBP and 24hBPL-DBP were negatively related with E/E′and were the protective factors for E/E′（P〈0.01,P〈0.05）.The regression equation was E/E′=0.062＋2.533×age＋3.765×24hSBP-2.919×24hDBP＋3.75×PP＋3.331×24h SBPL-1.933×24hDBPL.Conclusion DBP is significantly lower in elderly EH patients.Elevated SBP,PP,BPL and reduced DBP are the risk factors for the reduced heart diastolic function in such patients.

关 键 词：高血压 昼夜节律 冠心病 糖尿病 血压监测 便携式 

分 类 号：R544.11[医药卫生—心血管疾病]