高血压病患者昼夜血压节律与靶器官损害的关系

Relationship between circadian rhythm of blood pressure and target organ damage in patients with essential hypertension

目的探讨高血压患者昼夜血压节律改变与靶器官损害的关系。方法对117例高血压病患者进行动态血压监测,应用超声心动图检测室间隔厚度、左心室后壁厚度,应用彩色多普勒超声检测颈动脉斑块。结果动态血压监测显示24 h血压呈非勺型者61例(52.1%),呈勺型者56例(47.9%);非勺型组24 h收缩压、24 h舒张压、夜间收缩压、夜间舒张压均高于勺型组(P均<0.05);非勺型组室间隔肥厚、左心室后壁肥厚、颈动脉斑块检出率均较勺型组高(P均<0.05)。结论高血压病患者50%以上血压有昼夜节律异常,血压昼夜节律异常者左室肥厚、颈动脉斑块发生率明显增加。

Objective It is to explore the associations between the circadian rhythm of blood pressure and target organ damage in patients with essential hypertension（EH）.Methods 117 patients with hypertension were selected for ambulatory blood pressure monitoring of 24 h.Interventricular septum（IVS） and left ventricular posterior wall（LVPW） were measured by echocardiography.Carotid atherosclerosis was also measured by color Doppler ultrasonography.Results Non-dipper BP of 24 h blood pressure was 61 cases（52.1 %） and dipper BP was 56 cases（47.9 %） by ABPM monitoring.SBP and DBP of 24 h and night,IVS,LVPW and carotid atherosclerosis detecting rate were higher in non-dipper group than those of dipper group（P0.05）.Conclusion The circadian rhythm of blood pressure is abnormal in EH patients more than 50%,and the occurrence of left ventricular hypertrophy and carotid atherosclerosis significantly increase in non-dipper EH patients.