老年高血压患者的动态血压和脉压与靶器官功能损害的关系

The Relationship between the ambulatory blood pressure and pulse pressure and target organs damage

目的探讨老年高血压患者动态血压和脉压变化特点与心、脑血管靶器官功能损害的关系。方法将93例70岁以上的患者分为A组,61例60岁以下的患者分为B组,进行动态血压、超声心动图和临床常规检查。结果A组偶测收缩压、MSBP/24h、MSBPD、MSBPN、PP、LA、LV、BUN、Cr、空腹血糖及脑梗塞和冠心病显著>B组(P<0.05和0.01)。B组偶测舒张压、MDBP/24h、MDBPN显著高于A组(P<0.05)。LVPW、IVS、LVM、LVEF、E/A、HR及心肌梗死、急性左心衰和脑出血两组间差异无统计学意义。相关分析表明,A组LVM与MSBPN和PP相关(P<0.05)。两组脑出血患者的MSBP/24h、MSBPN和PP均显著高于无脑出血患者(P<0.05)。结论70岁以上的老年高血压患者动态血压各值均以收缩压和脉压增高为主。左室重量与MSBPN和PP差异有统计学意义,并存脑梗塞和冠心病显著性增加。脑出血与MSBP/24h、MSBPN和PP可能存在一定的内在关系。

Objective To investigate the characteristics of ambulatory blood pressure and pulse pressure of old hypertension patients and their correlation with the target organs damage. Methods Patients were divided into two groups, 93 patients over 70 in group A and 61 patients younger than 60 in group B. 24h ambulatory blood pressure monitoring and Color Doppler echocardigram were observed in all patients. Results Occasional SBP, MSBP/24h, MSBPD, MSBPN, PP, LA, LV, BUN, CR, blood sugar of empty stomach, cerebral infarction and coronary heart disease were significantly increased in group A compared with group B, (P<0.05 or 0.01=. Occasional DBP, MDBP/24h, MDBPN were significantly increased in group B compared with group A,(P<0.05=. There were no great differences in LVPW, IVS, LVM, LVEF, E / A, HR, myocardial infarction, urgent heart failure and cerebral hemorrhage. By regression analysis, LVM was related to MSBPN and PP in group A, (P<0.05=. MSBP / 24h, MSBPN and PP of cerebral hemorrhage patients were much higher than the patients who not having cerebral hemorrhage in the two groups. Conclusion The increasing of SBP and PP were the major part of ambulatory blood pressure monitoring of old hypertension patients over 70. Left ventricular mass, MSBPN and PP were quite different. Cerebral infarction and coronary heart disease increased sharply. There may be certain inherent relations between cerebral hemorrhage, MSBP/24h, MSBPN and PP.