不同昼夜节律高血压患者的主动脉重构性变化

The aortic remodeling in essential hypertension patients with circadian blood pressure rhythms

目的研究不同血压昼夜节律性对高血压病时主动脉重构的影响。方法对64例1．2级高血压病患者进行24h动态血压监测，并以二维超声检测主动脉重构指标，对比动态血压昼夜节律呈杓型和非杓型的高血压病患者主动脉重构的差异及程度，同时以36例正常血压者作对照。结果血压昼夜节律异常的非杓型组患者与正常血压对照组相比，主动脉内膜中层厚度及面积增大，内膜中层厚度，腔径比值及内膜中层面积，管腔面积比值显著增高；主动脉还有管腔内径及面积增大，脉搏波速度明显增快，差异有统计学意义，经协方差分析校正可能的影响后，差异的显著性仍然存在。讨论高血压病时，血压昼夜节律异常可能加重主动脉重构的程度。

Objective To investigate the aoaie remodeling in patients with essential hypertension under the different circadian blood pressure rhythms. Methods Ambulatory blood pressure monitoring and measurements of aortic structure and the functions of aortic were performed by echocardiography and vascular ultrasound technique in 64 patients with essential hypertension from mild to moderate. The differences of indices of arterial structure and function were compared between the dipper and non - dipper hypertensive groups and 36 nonnotensive subjects as controls. Results The wall intimal - medial thickness （IMT） and area （WSA） or intimal- medial thickness/internal dimension ratio （T/D） of aortic have increased in the non - dipper group. The statistical significance of differences of index of aortic remained after adjusting for the confounding effects of other variables which may affect on aortic remodeling. It is suggested that abnormality of circadian blood pressure rhythms may deteriorate aortic remodeling in mild or moderate patients with essential hypertension.