血压动态变量及心率变异性与原发性高血压左室重构的关系

Effects of left ventricular remodeling on ambulatory blood pressure parameters and heart rate variability with essential hypertension

目的利用动态血压和动态心电图监测技术分析其血压动态变量及心率变异性(HRV)指标与原发性高血压患者左室重构的关系。方法选择1,2级原发性高血压病患者168例进行超声心动图、动态血压及动态心电图检查,依据左室构型将高血压病患者分为第1,2,3,4组,4组分别为正常左室构型、向心性重构、向心性肥厚和离心性肥厚的患者。对4组的动态血压各项指标及HRV时域指标进行统计分析。结果4组间收缩压各项指标均有显著差异(P<0.05)。第3,4组的24h平均收缩压、夜间平均收缩压和收缩压负荷值均较第1,2组高,第3组的白昼平均收缩压较其他3组高。第3,4组的夜间舒张压较第1,2组高。第3,4组的HRV各时域指标较第1,2组均下降,其三项指标降低有显著性(P<0.05)。结论收缩压水平和HRV异常是高血压左室构型改变的重要危险因素。

Objective To explore the relationship between left ventricular remodeling and indices of ambulatory blood pressure parameters and heart rate variability （HRV） in patients with essential hypertension. Methods One hundred and sixty-eight patients with essential hypertension were divided into normal ventricle structure group（ 1 st group）, centripetal ventricle remodeling group（2nd group）, centripetal ventricle hypertrophic group （3rd group）, and centrifugal ventricle hypertrophic group（4th group） based on Ganau Criteria. Ambulatory blood pressure parameters and HRV were determined with statistics among four groups. Results There were differences in the indices of systolic pressure between the four groups. There were differences of diastolic pressure at night between 1 st or 2nd group and 3rd or 4th group. No significant difference were found in other indices of diastolic pressure. There were differences of HRV between 1st or 2nd groups and 3rd or 4th group. Conclusion Indices of systolic pressure of ambulatory blood pressure monitoring and HRV are important risk factors in left ventricle remodeling.