老年高血压患者血压节律与左心室结构和功能的相关性研究  被引量:3

Correlation between blood pressure rhythm and left ventricular structure and function in elderly hypertension patients

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作  者:邓微微 叶水芬 曾美娥 陈彬 钟锦荣 Deng Weiwei;Ye Shuifen;Zeng Meie;Chen Bin;Zhong Jinrong(Department of General Practice, the First Hospital of Longyan Affiliated to Fujian Medical University, Longyan, Fujian 364000, China)

机构地区:[1]福建医科大学附属龙岩第一医院全科医学科,364000

出  处:《中国基层医药》2019年第8期963-967,共5页Chinese Journal of Primary Medicine and Pharmacy

摘  要:目的探讨老年高血压患者血压节律变化与左心室结构和功能的相关性。方法选择福建医科大学附属龙岩第一医院2017年1-12月诊治的老年高血压患者147例,患者均接受24 h动态血压检查,根据血压节律分为杓型、非杓型及反杓型血压三组,患者均进行心脏超声心动图检查,分析动态血压相关参数与左心室结构和功能的相关性。结果147例老年高血压患者中,杓型血压占11.56%(17/147),非杓型血压占51.02%(75/147),反杓型血压占37.41%(55/147)。非杓型血压组室间隔厚度(IVST)、左室舒张末内径(LVEDD)、左房内径(LAD)、左室后壁厚度(LVPWT)、左心室质量指数(LVMI)分别为(10.56±1.51)mm、(50.17±4.31)mm、(34.65±5.78)mm,(9.26±0.98)mm,(102.31±23.23)g/m2,反杓型血压组分别为(10.51±1.86)mm,(50.20±3.66)mm,(36.96±4.22)mm、(9.42±0.99)mm、(110.47±31.96)g/m2,杓型血压组分别为(9.53±1.53)mm、(47.59±2.27)mm、(30.47±4.17)mm、(8.88±1.12)mm、(84.98士15.48)g/m2,三组差异均有统计学意义(F=l.172 3-428 J.006.0.135,均P<0.05);非杓型血压组、反杓型血压组二尖瓣血流频谱舒张早期最大血流速度(E峰)/舒张晚期最大血流速度(A峰)(E/A)比值分别为(0.89±0.30)、(0.80±0.28),均较杓型血压组[(1.35±0.63)]明显降低(t=-2.890、-3.440,均P<0.05);反杓型血压组的左室射血分数(LVEF)为(65.31±6.74)%,较杓型血压组的(70.12+10.76)%明显减低,差异有统计学意义(t=-2.209,P<0.05)。三组动态血压参数中24 h平均收缩压、24 h平均舒张压、白天平均舒张压差异均无统计学意义(均P>0.05)。杓型血压组白天平均收缩压(143.06±13.70)mmHg,高于非杓型血压组的(133.25±13.28)mmHg和反杓型血压组的(131.16±12.26)mmHg,差异均有统计学意义(t=-2.734、-3.401,均P<0.05)。反杓型血压组夜间收缩压(139.04±15.01)mmHg、夜间舒张压(80.18±10.29)mmHg,均高于杓型血压组的(123.24±14.49)mmHg、(72.24±7.97)mmHg和非杓型血压组的(127.40±13.30)mmHg、Objective To investigate the correlation between blood pressure rhythm and left ventricular structure and function in elderly hypertensive patients.Methods A total of 147 elderly patients with high blood pressure in the First Hospital of Longyan Affiliated to Fujian Medical University were selected.All the patients received 24h ambulatory blood pressure examination.According to the rhythm of blood pressure,the patients were divided into the dipper blood pressure group,the-non dipper type blood pressure group and the anti-dipper type blood pressure group..All patients were examined by echocardiography.Results According to the results of 24h dynamic blood pressure,the type of dipper blood pressure accounted for 11.56%(17 cases)in 147 elderly patients,non-dipper type blood pressure type accounted for 51.02%(75 cases),and the anti-dipper type of blood pressure type acco unted for 37.41%(55 cases).The ventricular septal thickness(IVST),left ventricular diastolic inner diameter(LVEDD),left atrium inner diameter(LAD),left ventricle posterior wall thickness(LVPWT)and left ventricle mass index(LVMI)of the non-dipper blood pressure group were(10.56±1.51)mm,(50.17±4.31)mm,(34.65±5.78)mm,(9.26±0.98)mm,(102.31±23.23)g/m2,respectively.The IVST,LVEDD,LAD,LVPWT and LVMI of the anti-dipper blood pressure group were(10.51±1.86)mm,(50.20±3.66)nnn,(36.96±4.22)mm,(9.42±0.99)mm,(110.47±31.96)&/?n2,respectively.The IVST,LVEDD,LAD,LVPWT and LVMI of the dipper blood pressure group were(9.53±1.53)mni,(47.59±2.27)mm,(30.47±4.17)mm,(8.88±1.12)mm,(84.98±15.48)g/m2,respectively.The differences of IVST,LVEDD,LAD,LVPWT and LVMI in the three groups were statistically significant(F=1.172,3.428,1.006,0.135,all P<0.05).The maximum blood flow velocity in early diastolic period of mitral valve blood flow spectrum(E peak)/maximum blood flow velocity in late diastolic period(A peak)(E/A)of the non-dipper blood pressure group and anti-dipper blood pressure group were(0.89±0.30),(0.80±0.28),respectively,which was significantly lower than

关 键 词:高血压 血压 昼夜节律 血压监测 便携式 超声心动描记术 心室功能  心脏扩大 老年人 

分 类 号:R544.1[医药卫生—心血管疾病]

 

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