探讨血压负荷值与无症状性心肌缺血的关系

The Relationship between Blood Pressure Load and Silent Myocardial Ischemia

目的探讨原发性高血压患者单纯收缩期高血压、单纯舒张期高血压血压负荷值与SMI的相关关系。方法选择同步ABPM及DCG的高血压患者120例(A组单纯收缩期高血压60例,B组单纯舒张期高血压60例)。血压负荷值:轻度负荷(10.1%～40.0%)、中度负荷(40.1%～80.0%)。根据24h血压负荷值把患者分轻度(A1组、B1组各30例)、中度(A2组、B2组各30例),分别中度组与轻度组比较、在同等程度血压负荷下B组和A组比较;各组间分白昼、夜间,各组夜间与白昼进行比较、中度组与轻度组(A组间、B组间)以及同等程度血压负荷下B组和A组间(夜间组、白昼组)分别进行比较,比较不同组间ST段压低程度、持续时间及发作次数。结果24h血压负荷值各组比较:轻度负荷下B1与A1组比较差异有统计学意义(P<0.05),其它各组差异均有统计学意义(P<0.01);血压负荷值各组夜间与白昼比较:轻度负荷时A1组夜间与白昼比较差异无统计学意义,B1组差异有统计学意义,其它各组差异均有统计学意义。结论单纯收缩期、舒张期原发性高血压病患者SMI的发作频率、ST段压低程度、持续时间都随着24h、白昼、夜间血压负荷值增高而增加,特别是中度负荷以上,且在同等程度负荷下夜间尤甚,舒张压比收缩压更为显著。

Objective To investigate the relationship between isolated systolic hypertension, blood pressure load in isolated di- astolic hypertension and SMI in patients with essential hypertension, Methods 120 cases of hypertensive patients with synchro- nous ABPM and DCG were selected. Group A was 60 cases of isolated systolic hypertension, group B was 60 patients with diastolic blood pressure. Blood pressure load values ： mild load （ 10.1% -40.0% ）, moderate load （40.0 % -80.0% ）. According to the value of 24 h blood pressure load： the patients were divided into sub.mild（ A1 group, B1 group of 30 cases）, moderate（ A2 group, B2 group of 30 cases）, respectively, moderate group and mild group, in the same degree of blood pressure load B group and A group; each group sub-daytime,evening,night and day for each group compared to moderate group and mild group（A between the two groups, B groups）, and the same degree of blood pressure load, B group and A group Inter（night group, the daytime group）were compared between the two groups to compare different degree of ST segment depression,duration and frequency of attacks. Resuits 24 h blood pressure load in each group comparison, mild load, B1 and A1 groupp,there was significant difference（P 〈0. 05）,other groups had significant difference（ P 〈 0. 01 ）;blood pressure load in each group at night and daylight comparison： mild load： A1 group, there was no significant difference between the night and the day, B1 group, significant differences in the other groups were very significant. Conclusion Isolated systolic, diastolic essential hypertension patients with SMI in seizure frequency .ST segment depression in the extent, duration, both with the 24 h, daytime, nighttime blood pressure values increased the load increased, especially in moderate load above, and at the same level of load, worse at night, diastolic blood pressure was more prominent than the systolic blood pressure.