高血压病人昼夜血压变化与靶器官损害的关系

Relationship between Diurnal Blood Pressure Variations and Target Organs Damage in Essential Hypertension Patients

目的:研究高血压病人昼夜血压变化与靶器官损害的关系及其临床意义。方法:将68例原发性高血压Ⅰ期和Ⅱ期病人,按照血压昼夜变化分为杓型组与非杓型组。比较两组病人24小时动态血压及尿微量蛋白、室间隔厚度、左心室舒张末直径、左心室后壁厚度、左心室重量。结果:非杓型组左心室重量和平均24小时动态血压、夜间收缩压、睡眠时最低舒张压,与杓型组比均有显著性差异。结论:非杓型组原发性高血压病人靶器官损害程度较杓型组病人更为明显。积极调节、改善非杓型高血压病人血压昼夜变化的功能,对防止靶器官损害更具有临床意义。

Objective:To study the relationship and clinical significance between diurnal blood pressure variations and target organs damage in essential hypertension patients. Methods: According to 24 hours ambulatory blood pressure monitoring (ABPM), 68 patients with essential hypertension in stages Ⅰ and Ⅱ were classified as dipper type group and non-dipper type group. All patients were examined with echocardiography, ABPM and urinary albumin test. The relationships between ABP and thick-ness of interventricular septum, left ventricular internal diameter at end diastole, posterior wall thickening, left ventricular mass and urinary albumin were compared between the two groups. Results: Non-dippers were significantly different to dip-pers in LV mass, urinary albumin, mean 24h ABP, night SBP and the lowest SBP at night. Conclusion: The severity of target organs damage in non-dippers was greater than dippers. The regulative function for diurnal blood pressure variations should be improved to prevent the target organs damage in non-dipper type hypertension patients.