高血压患者动态血压与心肌缺血和左心室肥大的关系  

The relationship among ambulatory blood pressure monitoring and myocardial ischemia and left ventricular hypertrophy in patients with essential hypertension

作　　者：罗昭林[1] 何作云[1] 钟杭美[1] 张晓燕[1] 文芳[1] 

机构地区：[1]解放军第三军医大学新桥医院心内科全军心血管病中心,重庆市400037

出　　处：《中国临床康复》2003年第9期1388-1389,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的监测高血压患者动态血压变化,探讨与心肌缺血(MI)和左心室肥大(LVH)之间的关系。方法对92例高血压患者同步进行动态心电图和动态血压监测,根据有无MI分为:MI组38例和无MI组54例。结果(1)两组间比较24h和夜间平均收缩压(SBP)、平均舒张压(DBP),白天平均DBP差异均显著(P<0.05,t=3.96,3.00,2.76,4.35,4.63);(2)两组间最高SBP和最高DBP均无差异(P<0.05,t=1.04,1.19,0.91,1.19,1.80,0.96);(3)两组间24hSBP负荷、夜间SBP负荷和DBP负荷差异显著(P<0.05,t=2.30,2.50,2.60);(4)伴有MI的患者,血压呈“杓型”变化的发生率明显低于无MI的患者(P<0.005,χ2=9.85);(5)伴有MI的患者,其LVH的发生率明显高于无MI患者的发生率(P<0.005,χ2=13.56)。结论高血压患者持续的血压增高,尤其是夜间持续升高,血压负荷增大,对LVH的发生发展起着重要的作用。Aim To explore the relationship of ambulatory blood pressure monitoring (ABPM) and myocardial ischemia (MI) and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH).Methods Ambulatory electrocardiogrophy and ABPM were simultaneously performe in 92 patients with EH (38 patients with MI, 54 patients without MI).Results (1)24 hour and nighttim mean systolic blood presure (SBP),mean diastolic blood pressure (DBP) and daytime mean DBP were significanty different between the patients with MI and without MI ( P< 0.05,t=3.96,3.00,2.76,4.35,4.63) . (2)The highest SBP and DBP were no significant difference between the two group( P< 0.05,t=1.04,1.19,0.91,1.19,1.80,0.96) . (3)24 hour SBP load, nighttime SBP load and DBP load were significanty different between the patients with MI and without MI( P< 0.05,t=2.30,2.50,2.60) .(4)The incidence of the blood pressure(BP) was ' dipper' was lower in the patients with MI and without MI( P< 0.005,χ 2=9.85) . (5)The incidence of LVH was higher in the patients with MI and without MI( P< 0.005,χ 2=13.56) .Conclusion Continuous hypertension and high blood pressure load especially at night play a significant role in the pathogenesis of left ventricular hypertrophy.Left ventricular hypertrophy could destroy coronary artery , and induce MI in patients with EH . <P>

关 键 词：高血压 动态血压 心肌缺血 左心室肥大 动态心电图 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]