老年高血压患者血压昼夜节律与左心室肥厚的相关性

Relationship between day-night rhythm of blood pressure and left ventricular hypertrophy in the elderly with hypertension

目的探讨老年高血压患者血压昼夜节律与左心室肥厚的相关性。方法根据动态血压监测结果将60例患者分为正常昼夜节律组(n=34)和异常昼夜节律组(n=26),并对患者行心脏超声检查,测定室间隔厚度(IVST)、左心室舒张末期内径(LVDd)和左心室后壁厚度(LVPWT),按Devereux公式计算各自的左心室质量(LVM)和左心室质量指数(LVMI)。结果两组年龄、体质量指数、总胆固醇、甘油三酯、空腹血糖、全天平均收缩压、全天平均舒张压、白天平均收缩压、白天平均舒张压、IVST和LVDd比较均无显著性差异。两组夜间平均收缩压、夜间平均舒张压、LVPWT、LVM和LVMI比较有显著性差异(P<0.05)。异常昼夜节律组左心室肥厚检出率显著高于正常昼夜节律组(P<0.01)。结论老年高血压患者血压昼夜节律与左心室肥厚显著相关,异常的血压昼夜节律提示可能存在更严重的心室肌损伤。

Objective To investigate the relationship between day-night rhythm of blood pressure and left ventricular hypertrophy（ LVH ） in the elderly with hypertension. Methods Accordig to the result of ambulatory blood pressure monitoring, 60 pantients were divided into two groups of normal day-night rhythm （ n = 34） and abnormal day-night rhythm （n =26）. All patients were performed ultrasonic cardiography. The interventricular septal thickness （IVST）, the left ventricular end diastolic dimension （LVDd） and the left ventricular posterior wall thickness （LVPWT） were recorded, and the left ventricular mass （LVM） and the left ventricular mass index （LVMI） were calculated according to the Devereux formula. Results There were no significant differences in age, body mass index, serum total cholesterol, triglyceride, fasting blood glucose, 24 h mean systolic blood pressure, 24 h mean diastolic blood pressure, day time mean systolic blood pressure, day time mean diastolic blood pressure, IVST and LVDd between the the two groups. However, there were significant differences in night time mean systolic blood pressure, night time mean diastolic blood pressure, LVPWT , LVM and LVMI between the two groups （P 〈0.05）. The detection rate of LVH of the group of abnormal day-night rhythm was significantly higher than that of the group of normal day-night rhythm （ P 〈 0.01 ）. Conclusion There is significant correlation between day-night rhythm of blood pressure and LVH in the elderly with hypertension. Abnormal day-night rhythm of blood pressure indicates the possibility of more severe ventricular muscle damage.