勺型和非勺型血压类型与心脏舒张功能不全的相关性  

Relationship between dipping and non-dipping blood pressure pattern with diastolic dysfunction

作　　者：黄国定[1] 翟剑凤 黄秀祝 HUANG Guo-ding;ZHAI Jian-feng;HUANG Xiu-zhu(Department of No.6 Internal Medicine,The First People′s Hospital,Danzhou,Hainan 571700,China)

机构地区：[1]海南儋州市第一人民医院内六科,海南儋州571700

出　　处：《岭南心血管病杂志》2017年第6期744-747,共4页South China Journal of Cardiovascular Diseases

基　　金：海南省卫生计生行业科研项目:不同血压类型对高血压及健康人群心脏结构和功能的影响(项目编号:15A200003)

摘　　要：目的探讨血压正常人群中,勺型和非勺型血压类型与左心舒张功能不全的相关性。方法入选行经胸心脏超声心动图检查且血压正常人群共328例,收集所有入选者基线资料,进行24 h动态血压检查,依据结果分为勺型和非勺型血压类型组,进行组间比较,同时进行Logistic回归分析。结果 (1)与勺型组人群相比,非勺型组人群年龄较大,高敏C-反应蛋白浓度和空腹血糖浓度均较高,差异有统计学意义(P<0.05);以此同时,非勺型组人群左心舒张功能不全患者比例较勺型组高,差异有统计学意义(21.5%vs.16.7%,P<0.05);(2)非勺型组人群全天平均收缩压、全天平均心率、夜间平均收缩压、夜间平均心率和夜间平均收缩压/白天平均收缩压比值均明显升高,差异有统计学意义(P<0.05);(3)舒张功能不全人群中,与勺型组相比,非勺型组人群全天平均收缩压、夜间平均收缩压、夜间平均心率和夜间平均收缩压/白天平均收缩压比值均明显升高,差异有统计学意义(P<0.05);(4)Logistic回归分析提示,在校正年龄、男性、吸烟、空腹血糖、高敏C-反应蛋白后,夜间平均收缩压(OR=2.23,95%CI:1.66~2.82,P<0.05)和非勺型血压类型(OR=1.97,95%CI:1.25~2.43,P<0.05)与左心舒张功能不全仍具有独立相关性。结论血压正常人群中,非勺型血压类型与左心舒张功能不全具有独立相关性。Objectives To investigate the relationship between dipping and non-dipping blood pressure pattern withdiastolic dysfunction.Methods A total of328participants with normal blood pressure who had undergone trans-tho?racic echocardiography were enrolled.Baseline characteristics were collected and then ambulatory blood pressure moni?toring(ABPM)was performed.Based on results of ABPM,participants were divided into dipping and non-dippinggroups and between-group differences were compared.Logistic regression analysis was conducted.Results(1)Com?pared to dipping group,participants in non-dipping group was older,and had higher concentrations of high sensitivityC-reactive protein(hs-CRP)and fasting plasma glucose(PFG);in addition,the proportion of participants with dia?stolic dysfunction was also higher in non-dipping group(21.5%vs.16.7%,P<0.05);(2)Compared with dippinggroup,those in non-dipping group had significantly higher24h mean systolic blood pressure(SBP)and heart rate,mean nighttime SBP and heart rate,and nighttime/daytime SBP ratio(P<0.05);(3)Among populations with diastolicdysfunction,compared with dipping group,those in non-dipping group had significantly higher24h mean SBP,meannighttime SBP and heart rate,and nighttime/daytime SBP ratio(P<0.05);(4)Logistic regression analysis showed thatafter adjusting for age,gender,smoking,FPG and hs-CRP,mean nighttime SBP(OR=2.23,95%CI:1.66-2.82,P<0.05)and non-dipping blood pressure pattern(OR=1.97,95%CI:1.25-2.43,P<0.05)were still significantly indepen?dently associated with diastolic dysfunction.Conclusions In subjects with normal blood pressure,non-dipping bloodpressure pattern independently associates with diastolic dysfunction.

关 键 词：动态血压 非勺型 舒张功能不全 

分 类 号：R544.1[医药卫生—心血管疾病]