原发性高血压患者血压晨峰现象与左室肥厚的关系

The Relationship between the Morning Blood Pressure Peak and the Left Ventricular Hypertrophy in Patients with Essential Hypertension

目的研究原发性高血压患者血压晨峰(MBPS)的发生与左室肥厚的关系.方法对115例入选的原发性高血压患者的血压采用24 h动态血压监测仪(ABPM)分析,将患者分为晨峰组(53例)和非晨峰组(62例)进行血生化测定,超声心动图检查测定左心室舒张末期内径(LVEDd)、室间隔厚度(IVST)、舒张末期左心室后壁厚度(LVPWT),计算左心室质量指数(LVMI).结果晨峰组(MBPS)24 h平均收缩压(24hSBP)、24 h平均舒张压(24 dSBP)、白昼平均收缩压(dSBP)、夜间平均收缩压(nSBP)、24 h平均脉压(24hPP)均高于非晨峰组(NMBPS),P<0.05;MBPS组的LVMI显著高于NMBPS组[(135±27)g/m2和(112±27)g/m2,P<0.01],差异有统计学意义.结论原发性高血压有晨峰现象者更易发生左心室肥厚.

Objective To investigate the relationship between the morning blood pressure peak and the left ventricular hypertrophy in patients with essential hypertension. Methods The dynamic blood pressure of l l5 patients with essential hypertension was detected with the 24-hour ambulatory blood pressure monitor analyzer. The 115 patients were divided into 2 groups： early morning peak group and non morning peak group. The blood biochemical indices were tested, the left ventricular end-diastolic diameter and interventricular septum thickness, and end-diastolic left ventricular posterior wall thickness were detected by ultrasonic electrocardiogram inspection, and the left ventricular mass index was calculated. Results The 24 hours average systolic blood pressure, 24 hours average diastolic blood pressure, average day systolic blood pressure and average night systolic blood pressure, 24 hours average pulse pressure of patients in morning peak group were higher than the non morning peak group （P〈0.05）. The left ventricular mass index patients in morning peak group was significantly higher than the non morning peak group （P 〈0.01 ）. Conclusion Left ventricular hypertrophy tends to occur in primary hypertension patients who have morning blood pressure peak phenomenon.