急性心肌梗死患者血压变异性与心室重构的相关性研究

Correlation between blood pressure variability and ventricular remodeling in patients with acute myocardial infarction

目的研究急性心肌梗死患者血压变异性(blood pressure variability,BPV)与心室重构的相关性及意义。方法根据24h收缩压BPV的总变异系数(coefficient variation,CV)将120例急性心肌梗死患者分为两组:高CV组(CV>12.16%)和低CV组(CV≤12.16%),记录两组BPV值。所有患者均于24h内及180d行超声心动图检查测定左室舒张末期内径(LVEDd)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及左室射血分数(LVEF)。比较两组患者的BPV与心室重构的相关性。另选30名体检健康者为正常对照组。结果与正常对照组比较,急性心肌梗死患者BPV值均增大(P<0.05),高CV组显著高于低CV组(P<0.05～0.01);在治疗180d时,高CV组LVEDV、LVESV及LVEF显著高于低CV组(P<0.05)。LV-EDV、LVESV与24h收缩压BPV值呈正相关(r分别为0.7963、0.594,P均<O.05)。结论急性心肌梗死患者血压变异性与心室重构密切相关。

Objective To study the significance of blood pressure variability（BPV） and the correlation between BPV and ventricular remodeling in the patients with acute myocardial infarction（AMI）.Methods According to the coefficient variation（CV） of 24-huor BPV of systolic blood pressure,AMI patients（n=120） were divided into two groups：high CV group（CV12.16%） and low CV group（CV≤12.16%）.All values of BPV were recorded in two groups.Within 24 hours and 180 days,left ventricular end-diastolic inner diameter（LVEDd）,left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV） and left ventricular ejection fraction（LVEF） were determined with echocardiogram in all patients.The correlation between BPV and ventricular remodeling were compared in two groups.Other 30 health people were selected as the normal control group.Results Compared with the normal control group,all values of BPV increased in AMI patients（P0.05）,and were higher in the high CV group than those in the low CV group（P0.05~0.01）.After treatment for 180 days,LVEDV,LVESV and LVEF were significantly higher in the high CV group than those in the low CV group（P0.05）,and LVEDV and LVESV were positively correlated to the value of BPV of 24-hour systolic blood pressure（r=0.7963,0.594 respectively,all P0.05）.Conclusion BPV is closely correlated to ventricular remodeling in AMI patients.