原发性高血压病患者血压变异性对左室肥厚影响的临床研究

Effect of blood pressure variability on left ventricular hypertrophy in patients with primary hypertension: a clinical study

目的探讨原发性高血压患者血压变异性(blood pressure variability,BPV)对左室肥厚的影响。方法收集原发性高血压患者110例,使用无创携带式动态血压监测仪检测出研究对象24小时血压,计算24小时收缩压变异(24 h BPVs)、24小时舒张压变异(24 h BPVd),以此将研究对象分组,并采用心脏彩色多普勒超声,测定左心室舒张末期内径(left ventricle end diastolic diameter,LVDd),左心室后壁厚度(posterior wall thickness,PWT)和室间隔厚度(Inter ventricular septal thickness,IVST)等,计算出左室质量指数(left ventricular mass index,LVMI),以此评价左室肥厚程度。用单因素直线相关分析高血压病患者血压变异性对左室肥厚影响。结果 (1)在不同血压变异性分组的原发性高血压患者中,血压变异性越大的组别,其LVMI值越大,差异有统计学意义(P<0.05),其中收缩压变异性分组中各组的LVMI比较,其差异性较舒张压变异性分组的显著(P<0.01)。(2)在所有受试者中,单因素相关分析显示,24 h BPVs、24 h BPVd均与LVMI呈正相关。结论在原发性高血压患者中,随着BPV的增大,左室肥厚程度增加。2、BPV的大小对评估高血压性心脏损害程度有一定的价值。

Objective To investigate the effect of blood pressure variability （BPV） on left ventricular hypertrophy （LVH） in patients with primary hypertension. Methods A total of 110 patients with primary hypertension were selected in the study. A noninvasive portable ambulatory blood pressure monitoring instrument was used to measure the blood pressure within 24 h and calculate 24-h systolic BPV （BPVs） and 24-h diastolic BPV （BPVd）. These patients were grouped accordingly. Cardiac color Doppler ultrasound was used to measure left ventricular end-diastolic diameter, left ventricular posterior wall thickness, and interventricular septal thickness and calculate the left ventricular mass index （LVMI）, so as to evaluate the degree of LVH. Univariate linear regression analysis was used for evaluating the effect of BPV on LVH in patients with hypertension. Results The patient group with a higher BPV had a significantly higher LVMI （P〈0.05）, and the difference was significantly larger among the groups assigned by BPVs than among those assigned by BPVd （P〈0.01）. The univariate analysis showed that 24-h BPVs and 24-h BPVd were positively correlated with LVMI. Conclusion In patients with primary hypertension, the degree of LVH increases as BPV rises. The value of BPV is of certain value for evaluation of hypertensive heart damage.