血压昼夜节律与动脉重构及左室肥厚的关系

The causality of circadian blood pressure rhythms with aortic remodeling and left ventricular hypertrophy in primary hypertension patients

目的通过比较杓型与非杓型原发性高血压患者动脉重构、左室结构的参数变化，探讨原发性高血压患者血压节律类型对动脉重构及左室肥厚的影响。方法选取1、2级原发性高血压患者128例，行动态血压监测，根据夜间平均动脉压下降10％以上或以下的标准分为杓型组（56例）与非杓型组（72例），应用彩色多普勒超声检测颈总动脉内膜中层厚度（IMT）、左室舒张末期内径（LVEDD）、室间隔（IVS）、左室后壁（PW）厚度，计算左室重量指数（LVMI），脉搏波速度测定仪同时检测颈动脉-桡动脉（C—RPWV）、颈动脉一股动脉（C—FPWV）的脉搏波速度。比较两组间上述检测指标。结果非杓型组IMT较杓型组明显增厚（P〈0．05）；C～RPWV、C—FPWV及LVMI在非杓型组明显高于杓型组（P〈0．01）。结论非杓型血压较杓型血压对动脉重构和左室肥厚的影响可能更明显。

Objective To investigate the aortic and left ventricular remodeling in patients with primary hypertension under the different circadian blood pressure rhythms by comparing their parameters between the dipper and non-dipper hypertensive groups. Methods According to ambulatory blood pressure, 128 patients with primary hypertension were divided into dipper group of 56 and non-dipper group＇ of 72. They were examined intima-media thickness （IMT） of carotid artery by echocardiography. Automatic pulse wave velocity （PWV） measuring system was applied to examine carotid-femoral PWV （CFPWV） and carotid-radial PWV （CRPWV）. The left ventricular mass index （LVMI） was tested. The indexes obtained from each group were compared. Results Comparing to the dipper group, increased IMT, PWV, and LVMI were reflected respectively in the non-dipper group. Conclusions The effect of aortic and left ventricular remodeling demonstrated more obvious in the non-dipper hypertension than the dipper hypertension.