原发性高血压合并肿瘤患者血压变异性及心脏结构功能的临床特点  

Clinical Characteristics of Blood Pressure Variability and Cardiac Structure and Function in Patients with Essential Hypertension Complicated with Tumor

作　　者：李佳欣 石福天 李彩娥[2] 苏全斌 余静[2] LI Jiaxin;SHI Futian;LI Caie(The Second Hospital Clinical Medical School,Lanzhou University,Gansu 730030,China)

机构地区：[1]兰州大学第二临床医学院,730030 [2]兰州大学第二医院心内科,730030

出　　处：《医学研究杂志》2025年第2期82-87,共6页Journal of Medical Research

基　　金：国家自然科学基金地区科学基金资助项目(81960086,82160089)。

摘　　要：目的比较原发性高血压合并肿瘤患者动态血压监测(ambulatory blood pressure monitoring,ABPM)参数及心脏结构功能指标的差异,总结肿瘤与血压及心脏结构功能之间的关系。方法采用回顾性研究方法,选取2018年1月~2024年7月兰州大学第二医院收治的原发性高血压患者,筛选出肿瘤合并高血压组患者109例,高血压组患者98例,收集两组患者的一般资料、ABPM参数、超声心动图结果,分析两组患者的ABPM参数及心脏结构功能的差异性。结果与高血压组比较,肿瘤合并高血压组患者的夜间收缩压下降率、夜间舒张压下降率、白天和全天收缩压及舒张压标准差、左心室射血分数均降低(P均<0.05),左心室舒张末期内径、室间隔厚度均升高(P均<0.05)。Pearson相关性分析结果显示,夜间收缩压下降率与年龄、夜间收缩压、清晨收缩压呈负相关(P均<0.05);肿瘤合并高血压患者的的室间隔厚度与体重指数、夜间收缩压、夜间舒张压、全天舒张压呈正相关(P均<0.05)。多元线性回归分析结果显示,肿瘤及年龄增长是夜间收缩压下降率降低的独立危险因素。结论与高血压患者比较,肿瘤合并高血压患者表现为血压昼夜节律异常,左心室舒张末期内径增大、室间隔增厚、射血分数降低。原发性高血压患者合并肿瘤、年龄增长是影响夜间血压下降率的主要危险因素。Objective To compare the differences in ambulatory blood pressure monitoring(ABPM)parameters and cardiac structure and function indicators in patients with essential hypertension complicated with tumor,then to summarize the relationship between tumor and blood pressure and structural and function of the heart.Methods A retrospective study was conducted to select patients with essential hypertensive admitted to the Second Hospital of Lanzhou University from January 2018 to July 2024.A total of 109 patients with tumor combined with hypertension and 98 patients with hypertension were identified.General information,ABPM parameters,and echocardiography results of patients in the two groups were collected,to analyze the differences in ABPM parameters and cardiac structure and function between the two groups.Results Compared with the hypertension group,the tumor combined with hypertension group had a reduced nighttime systolic blood pressure fall rate,nighttime diastolic blood pressure fall rate,daytime and 24-hour systolic and diastolic blood pressure standard deviations,and left ventricular ejection fraction(all P<0.05),while the left ventricular end-diastolic diameter and interventricular septum thickness were increased(all P<0.05).Pearson correlation analysis revealed that the nighttime systolic blood pressure fall rate was negatively correlated with age,nighttime systolic blood pressure,and morning systolic blood pressure(all P<0.05).In the tumor combined with hypertension patients,the interventricular septum thickness was positively correlated with body mass index,nighttime systolic blood pressure,nighttime diastolic blood pressure,and 24-hour diastolic blood pressure(all P<0.05).Multiple linear regression analysis results indicated that tumor and increasing age were independent risk factors for the reduction in nighttime systolic blood pressure fall rate.Conclusion Compared with hypertensive patients,patients with tumor combined with hypertension exhibit abnormal blood pressure circadian rhythm,increased left ven

关 键 词：肿瘤 动态血压监测 夜间血压下降率 室间隔厚度 

分 类 号：R544[医药卫生—心血管疾病]