老年H型高血压患者血压特点及心脏结构的变化  

Blood Pressure Features and Cardiac Structure Changes of the Senile Patients with H-type Hypertension

作　　者：李龙心[1] 孙海清[1] 姚俊秀[1] 李鸿雁[1] 杨雪[1] Li Longxin Sun Haiqing Yao Junxiu Li Hongyan Yang Xue(Section 3, Cadre Ward, Chengdu Military General Hospital, Chengdu, Sichuan Province, 610083, P. R. China)

机构地区：[1]成都军区总医院干部病房三病区,四川成都610083

出　　处：《西南军医》2017年第4期308-311,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的探讨老年H型高血压患者血压特点及心脏结构的变化。方法随机选取我院2014年9月—2016年9月收治的新诊断的老年高血压患者共计120例,按照Hcy增高与否分为两组,每组60例,Hcy>10μmol/L的为H型高血压组;Hcy<10μmol/L的为非H型高血压组。对两组患者行24 h动态血压监测及心脏彩超检查。比较两组患者的24 h平均脉压差、24 h收缩压及舒张压变异系数、心脏超声各项指标的异同。结果H型高血压组的24 h平均脉压差、24 h收缩压和24 h舒张压变异系数均显著高于非H型高血压组,差异有统计学意义(P<0.05)。H型高血压组LA、LVEDD均较非H型高血压组增高,差异有统计学意义(P<0.05)。而RA、RVEDD、IVST、LVPWT H型高血压组较非H型高血压组也增高,但差异无统计学意义(P>0.05)。结论老年H型高血压患者的脉压差增大,且血压的变异系数增大。H型高血压患者LA、LVEDD均较非H型高血压组增高,提示Hcy可能与高血压患者的心脏结构变化有关。Objective To discuss the blood pressure features and cardiac structure changes of the senile patients with H-type hypertension. Methods 120 senile patients with hypertension newly confirmed were selected in the period from Sept. , 2014 to Sept. , 2016 and divided into 2 groups based on the level of homocysteine （Hcy） ： H-type group （Hcy 〉 10 μmol/L） and non H-type group （Hcy 〈 10 μmol/L）, 60 in each; patients in both groups receive 24-hour ambulatory blood pressure monitoring （ABPM） and echocardiographic exa mination; a comparative analysis was made to the 24-hour average pulse pressure difference, the coefficient of variation （CV） of 24-hour systolic pressure and di- astolic pressure, and the data of echocardiography between the patients in the 2 groups. Results The 24-hour average pulse pressure difference, the CV of 24-hour systolic pressure and diastolic pressure of the patients in H-type group were much higher than those of the patients in non H-type group, the difference was of statistical significance （P 〈 0. 05 ） ; the RA, RVEDD, IVST and LVPWT of the patients in H-type group were larger than those of the patients in non H-type group while the difference was of no statistical significance （P 〉 0. 05 ）. Conclusions The pulse pressure difference and the CV of blood pressure are higher in senile patients with H-type hypertension and the LA and LYEDD are larger than those in patients with non H-type hypertension, which indicates that Hcy may be related to the changes of cardiac structure in patients with hypertension.

关 键 词：HCY H型高血压 24 h动态血压监测 心脏彩超 

分 类 号：R544.1[医药卫生—心血管疾病]