原发性高血压患者血压变异性与左室舒张功能的关系  

Relationship between blood pressure variability and left ventricular diastolic function in patients with essential hypertension

作　　者：张之瀛[1] 王丽丽[1] 崔永亮[1] 尹燕平[1] 白艳[1] 苗立夫[1] ZHANG Zhi-ying WANG Li-Ji CUI Yong-liang YIN Yan-ping BAI Yan MIAO Li-fu(Heart Center, Beijing Huaxin Hospital, Beijing, 100016, China)

机构地区：[1]北京华信医院心脏中心,北京市100016

出　　处：《心血管康复医学杂志》2017年第1期33-36,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察原发性高血压患者动态血压变异性(BPV)与左心室舒张功能的关系。方法:入选初诊为原发性高血压的患者140例,根据24h收缩压BPV的总变异系数(CV)分为:高CV组(CV>12.16%)和低CV组(CV≤12.16%),每组70例。另入选70例同期年龄性别相匹配的健康体检者为健康对照组。采用超声心动图测定二尖瓣舒张早期血流峰值(E)、舒张晚期血流峰值(A)、E峰减速时间(DT),同时使用组织多普勒模式,记录舒张早期峰值速度(Em)、舒张晚期峰值速度(Am),比较各组间的差异。结果:与健康对照组比较,高血压患者BPV均明显增大(P<0.05或<0.01),除白昼平均舒张压变异性(dDBP-BPV)和夜间平均舒张压变异性(nDBP-BPV)外,高CV组其余各项BPV均明显高于低CV组(P均<0.05)。与健康对照组比较,高血压患者E、Em/Am值明显减小,DT、E/Em值明显增加(P<0.05或<0.01);高CV组E/Em值明显高于低CV组[(14.22±2.20)比(10.32±3.20),P=0.033]。结论:高血压患者动态血压变异性大者左心室舒张功能受损更显著。Objective： To observe the relationship between dynamic blood pressure variability （BPV） and left ventricular diastolic function in patients with essential hypertension （EH）. Methods： A total of 140 newly diagnosed EH patients were selected. According to total coefficient of variation （CV） of 24h systolic blood pressure BPV, they were divided into high CV group （n= 70, CV〉12.16%） and low CV group （n =70, CV≤12.16%）. Another 70 healthysubjects with corresponding gender and age were enrolled as healthy control group simultaneously. Echocardiography was used to measure mitral early diastolic peak flow velocity （E）, late diastolic peak flow velocity （A） and deceleration time of E peak （DT）; meanwhile, tissue Doppler mode was used to record early diastolic peak velocity （Em） and late diastolic peak velocity （Am）. All above indexes were compared among all groups. Results： Compared with healthy control group, BPV significantly rose in EH patients （PG0.05 or G0.01）. All BPV indexes in high CV group were significantly higher than those of low CV group except daytime mean diastolic blood pressure variability （dDBP-BPV） and nighttime mean diastolic blood pressure variability （nDBP-BPV）, PG0.05 all. Compared with healthy control group, there were significant reductions in E and Era/Am, and significant rise in DT and E/Em in EH patients, P〈0.05 or 〈0.01 ; compared with low CV group, there was significant rise in E/Em [ （10.32 ± 3.20） vs. （14.22 ± 2.20）, P = 0. 033] in high CV group. Conclusion： Left ventricular diastolic dysfunction is more severe in hypertensive patients with higher dynamic blood pressure variability.

关 键 词：高血压 心电描记术 便携式 超声心动描记术 多普勒 

分 类 号：R544.109[医药卫生—心血管疾病]