老年高血压患者动态血压参数对左室肥厚及颈动脉硬化影响的临床观察

Clinical Observation of the Effect on Left Ventricular Hypertrophy and Carotid Artery Atherosclerosis by Dynamic Blood Pressure Parameters in Senile Hypertension Patients

目的:观察老年高血压病患者动态血压参数对左室肥厚及颈动脉硬化的影响。方法:对明确诊断的老年高血压病患者227例进行超声心动图和颈动脉超声、动态血压监测检查,根据左室质量指数将患者分成左室肥厚组(n=63)和无左室肥厚组(n=164);根据颈动脉内-中膜厚度分为颈动脉IMT增厚组(n=87)及无增厚组(n=140)。测定动态血压参数,血脂等指标,并进行比较。结果:左室肥厚组与无左室肥厚组临床指标比较差异无统计学意义(P>0.05);24h、白昼、夜间的平均收缩压、舒张压、脉压、24hSBPV、24hDBPV、非勺型血压发生率等方面,左室肥厚组明显高于无左室肥厚组(P<0.05)。颈动脉IMT增厚组与无增厚组临床指标比较差异无统计学意义(P>0.05);24h、白昼、夜间的平均收缩压、舒张压、脉压、24h SBPV、24hDBPV,非勺型血压发生率等方面,颈动脉IMT增厚组明显高于无增厚组(P<0.05)。结论:老年高血压左室肥厚及颈动脉内-中膜增厚与动态血压参数密切相关,动态血压参数可能是影响老年高血压患者病情进展及预后的重要因素。

Objective： To investigate the effect of left ventricular hypertrophy and carotid artery atherosclerosis by dynamic blood pressure parameters in senile hypertension patients.Methods： The 227 senile hypertension patients underwent ultrasound examinations of the heart and the IMT of carotid arteries. They were classified as LVH group （n=63） and no LVH group （n=164） according to left ventricular mass index; They were also divided into IMT increase group （n=87）or no IMT increase group （n=140） to carotid intima-media thickness.The ABPM examination were performed in all patients.Then the data comparison was made.Results： （l）There were no significant differences in clinical manifestations and biochemical parameters between the groups with LVH and without LVH （P 〉0.05）;the levels of 24 h SBPL,24 h DBPL,dSBP,dDBP, Nsbpl,nDBPL,24 h PP,24 h SBPV ,24 h DBPV and the rate of non-dippers blood pressure in LVH group were higher than those in the group without LVH （P〈0.05）. （2）There were also no significant differences in clinical manifestations between the IMT increased and normal IMT groups （P〉0.05）;the levels of 24 h SBPL,24 h DBPL dSBP, dDBP, nSBPL,nDBPL,24 h PP,24 h SBPV ,24 h DBPV and the rate of non-dippers blood pressure in IMT increased group were higher than those in the group with normal IMT （P〈0.05）. Conclusion ：The LVH and IMT of carotid artery, correlated immediately with the parameter of ABPM in senile hypertension,those might play the important roles in the development and prognosis of senile hypertension.