动态血压与射血分数保留型心衰患者短期预后的关系分析  

Analysis of relationship between ambulatory blood pressure and short-term prognosis in patients with ejection fraction retained heart failure

作　　者：杨澄[1] 罗梅梅[1] 区雪娥 何惠仙 YANG Cheng;LUO Meimei;QU Xue′e;HE Huixian(Zhaoqing Medical College,Zhaoqing 526000,Guangdong province,China)

机构地区：[1]肇庆医学高等专科学校,广东省肇庆市526000

出　　处：《内科》2018年第6期834-836,885,共4页Internal Medicine

基　　金：2016肇庆市科技创新项目(201624030802)

摘　　要：目的分析动态血压与射血分数保留型心力衰竭(HFp EF)患者短期预后的关系。方法选取2015年1月至2016年12月在我院内科住院治疗的HFp EF患者60例进行规范治疗。随访1年,根据1年内是否因心衰再入院治疗的情况,将再入院治疗患者设为观察组,未再入院治疗的患者设为对照组,比较两组患者入院时,出院1个月、3个月、9个月的24小时动态血压以及血压昼夜节律的差异。结果 60例患者失访9例,死亡6例。再入院治疗患者(观察组) 29例,未再入院治疗患者(对照组)患者16例。观察组患者出院后1个月、3个月、9个月白昼平均收缩压及舒张压均显著低于对照组,出院后1个月、3个月的24小时平均收缩压和舒张压均也显著低于对照组,差异有统计学意义(P <0. 05)。观察组患者出院后1个月、3个月血压昼夜节律异常(非勺型血压)率显著高于对照组,差异有统计学意义(P <0. 05)。结论血压降低和血压昼夜节律减弱(消失)与射血分数保留型心衰患者预后不良密切相关。Objective To analyze the relationship between ambulatory blood pressure and short-term prognosis in patients with preserved ejection fraction heart failure (HFpEF).Methods 60 patients with HFpEF who were hospitalized in our hospital from January 2015 to December 2016 were selected and all were standardized treatment.After 1 year of follow-up,patients who were re-admitted to hospital were set as observation group,and patients who were not admitted to hospital were set as control group according to whether they were hospitalized for treatment due to heart failure within 1 year,the 24-hour ambulatory blood pressure and the circadian rhythm of blood pressure at admission and at 1 month,3 months,and 9 months after discharge were compared between the two groups.Results Of the 60 patients,9 were lost to follow-up,and 6 died.29 patients admitted to hospital once again,16 patients without re-admission.The average systolic blood pressure and diastolic blood pressure of the patients in the observation group at 1 month,3 months,and 9 months after discharge were significantly lower than those in the control group.The 24-hour mean systolic and diastolic blood pressure of the observation group at 1 month and 3 months after discharge were also significantly lower than the control group,the difference was statistically significant (P<0.05).The abnormality of blood pressure circadian rhythm (non-dipping blood pressure) was significantly higher in the observation group than in the control group at 1 month and 3 months after discharge,and the difference was statistically significant (P<0.05).Conclusion Decreased blood pressure and circadian rhythm of blood pressure (disappearance) are closely related to poor prognosis in patients with ejection fraction retained heart failure.

关 键 词：射血分数保留型心衰 动态血压 预后 

分 类 号：R541.6[医药卫生—心血管疾病]