高血压病患者动态血压与左心功能相关关系的研究

A study on the correlation between ambulatory blood pressure monitoring and left ventricular function in patients with essential hypertension

目的观察收缩压、舒张压分别对左室收缩及舒张功能的不同影响。方法应用诊所血压、２４小时动态血压监测及超声心动图，观察３８例Ⅰ、Ⅱ期高血压病患者血压与左室心肌质量、左室收缩及舒张功能的相关关系。结果２４小时及白天平均收缩压及诊所收缩压均与舒张早期充盈峰值流速（ＥＰＦＶ）呈负相关（Ｐ值均＜００５），２４小时、白天及夜间平均舒张压均与年龄呈负相关（Ｐ值均＜０．０５），与舒张功能各参数之间无相关关系，诊所收缩压与年龄、心房收缩期充盈峰值流速（ＡＰＦＶ）呈正相关（Ｐ＜０．００１及０．０５），夜间平均收缩压及诊所收缩压与左室心肌质量指数呈正相关（Ｐ＜０．０１及０．０５）。而２４小时平均收缩压、白天平均收缩压、２４小时平均舒张压、白天及夜间平均舒张压则均与左室心肌质量指数无明显相关关系。结论２４小时平均收缩压是影响左室舒张功能的重要因素之一，２４小时平均舒张压与左室舒张功能无相关关系。夜间平均收缩压增高是导致左心室肥厚的重要因素之一。随年龄增长，收缩压增高。

Objective To study the influence of systolic and diastolic blood pressure on left ventricular systolic and diastolic function. Methods 38 patients with essential hypertension were observed with ambulatory blood pressure monitoring and echocardiography. Results There was negative correlation between the average systolic blood pressure of 24 hours (24h SBP), average systolic blood pressure of the time (DSBP), office systolic blood pressure (OSBP) and early diastolic peak flow velocity (EPFV) ( P <0.05), but positive correlation between 24h SBP, DSBP, OSBP and the ratio between atrial peak flow velocity (APFV) and EPFV (A/E) ( P <0 05 and 0.01 respectively). Negative correlation was found between the average diastolic blood pressure of 24 hours (24h DBP), average diastolic blood pressure of day time (DDBP), average diastolic blood pressure of night time (NDBP) and age ( P <0.05), while positive correlation between OSBP and age, APFV ( P <0.001 and 0 05 respectively) as well as between average systolic blood pressure of night (NSBP), OSBP and left ventricular mass index (LVMI) ( P <0.001 and 0.05 respectively). There was no correlation between DDBP, NDBP and the data of left ventricular diastolic function as well as between 24h SBP, DSBP, 24h DBP, DDBP, NDBP and LVMI. Conclusion 24h SBP is one of the important influencing factors on left ventricular diastolic function; there was no correlation between 24h DBP and left ventricular diastolic function; NSBP is one of the important influencing factors on left ventricular hypertrophy. With increase of age, systolic blood pressure increased but diastolic blood pressure decreased.