高血压患者血压晨峰与左室肥厚及颈动脉硬化关系的研究

Relationship between morning blood pressure surge and left ventricular hypertrophy and carotid atherosclerosis

目的探讨高血压患者血压晨峰与左室肥厚及颈动脉硬化的关系。方法将入选的184例原发性高血压患者根据24 h动态血压监测结果分为血压晨峰(MBPS)组(106例)和非MBPS组(78例)。同时检查心脏超声及颈动脉超声并测量左心室质量指数(LVMI)和颈动脉内中膜厚度(IMT)。结果 MPBS组24 h、白天、夜间平均收缩压及脉压均在较高水平位置,舒张压晨峰也显著高于非MBPS组(P<0.05或P<0.01),差异具有统计学意义;MPBS组与非MBPS组相比,MBPS组左心室质量指数(LVMI)和颈动脉内中膜厚度(IMT)均高于非MBPS组(P<0.01);左心室肥厚检出率及颈动脉硬化检出率均显著高于非MBPS组的(P<0.01)。结论高血压患者血压晨峰是左室肥厚及颈动脉硬化的重要危险因素,积极干预有助于减少心脑血管事件的发生。

Objective To investigate the relationship between morning blood pressure surge and left ventricular hypertrophy and carotid atherosclerosis.Methods The selected 184 patients were divided into MBPS group（n=106）and the non-MBPS group（n=78）,according to their 24 h ambulatory blood pressure monitoring profiles.Meanwhile,cardiac ultrasound and carotid ultrasound were respectively taken,and left ventricular mass index（LVMI）and the intima-media thickness（IMT）of carotid were measured.Results The mean systolic blood pressures of 24 h,daytime,night and the 24 h pulse pressures in the MBPS group were all higher than those in the non-MBPS group（P0.05）.Meanwhile,the morning blood pressure surge of diastolic blood pressures in the MBPS group was higher than that in non-MBPS group（P0.01）.There were differences between them;The left ventricular mass index（LVMI）and the intima-media thickness（IMT）of carotid in the MBPS group were higher than those in the non-MBPS group（P0.01）;The detection rate of left ventricular hypertrophy and carotid atherosclerosis in the MBPS group were both higher than those in the non-MBPS group（P0.01）.There were differences between them.Conclusions The morning blood pressure surgey of the hypertrophy patients is an imporant risk factor to left ventricular hypertrophy and carotid atherosclerosis.Active intervention helps to reduce the occurrence of cardiovascular and cerebrovascular events.