动态脉压和老年高血压病患者左心质量及心电图的关系

Relation of ambulatory pulse Pressure on left ventricular hypertrophy and ECG in elderly patients with hypertension

目的探讨老年高血压病患者动态脉压和左心质量及心电图的关系。方法对128名初诊未治或治疗但未达到目标血压的老年高血压患者进行24h动态血压检测、超声心动图及心电图检查。根据脉压(PP)将患者分为3组,A组:PP<40mmHg;B组:40mmH≤PP<60mmHg;C组:PP≥60mmHg,比较各组的检查结果,分析其24h收缩压、舒张压、24h白昼、夜间的平均脉压、左室心肌重量指数及心电图等。结果3组血压参数比较,24hSBP、PP1、PP2及PP3均呈增高趋势。3组的左心质量各参数比较,与A组比较,B组LVM增加明显,相比差异有显著性(P<0.01),LVP-WT差异有显著性(P<0.05),余指标相比则差异无显著性;C组除LVEDd外,余指标均差异有显著性(P<0.01)。与B组相比,C组除LVEDd外,余指标差异有显著性(P<0.05或<0.01)。A、B两组的心电图差异无显著性,而C组与A组、B组比较均差异有显著性(P<0.05)。结论①动态脉压高的老年高血压患者更易导致左室肥厚和心电图的异常。②动态脉压可以作为老年人心血管疾病的一个有价值的预测因子。

Objective Study on the relation of ambulatory pulse pressure of elderly with hypertension on left ventricular mass and its ECG. Methods Monitor 24h. ambulatory blood pressure ,Echocardiogram and ECG. of 128 newly diagnosed elderly patients with hypertension or being diagnosed but not coming up to the present biood pressure. The patients are divided into 3 groups according to their pulse pressure. Compare the results of diffent groups , then analyze the results. Results The 24 SBP, PP1,PP2,PP3 of three Groups have an increase trend. Compared to Group A, 24h DBP don＇t change markedly, while LVM and LVPWI of Group B increase significantly（P 〈 0.05 or P 〈 0.01 ）. Compared to Group A, LVMI , IVST and LVEDd of Group B don＇t change markedly. Cpmpared to Group A and Group B,24h SBP and average pluse pressure of Group C increase significantly, the diastolic pressure don＇t change markedly and all the indexes of left ventricular mass change significantly （P 〈 0.05 or P 〈 0.01 ） except LVEDd. There＇s no significantly difference when the ECG of Group A was compared to that of Group B. However, the ECG of Group C changes singificantly compared to that of Group A and B （P 〈 0.05）. Conclusion elderly hypertensive pa- tients with higher ambulatory pluse pressure may cause left ventricular hypertrophy and abnormal ECG;ambulatory pulse pressure can be a remarkable element to forecast the cardiovascular disease of the elder.