动态血压负荷值对心功能影响的临床观察

Clinical research on ambulatory blood pressure loading value effect on cardiac function

目的 :探讨 2 4小时动态血压负荷值对原发性高血压患者心脏收缩及舒张功能有何影响。方法 :选择原发性高血压患者 80例 ,应用 2 4小时动态血压监测及超声心动图监测心功能的动力学指标 :左室射血分数 (LVEF) ,左室高峰充盈率 (PFR) ,左室高峰射血率 (PER)及二尖瓣血流舒张早期流速 (EV)与左心房收缩期流速 (AV)的比值 (EV/AV)。根据血压负荷值 <30 %和 >30 % ,将病人分为A、B、C、D四组 ,比较各组间心功能有无差异。结果 :A组与B组比较 ,PFR有显著性差异 ,A组与C组、D组比较 ,LVEF和EV/AV有显著性差异性 (P <0 0 5 ) ,PFR有非常显著性差异 (P <0 0 1) ,C组与D组比较LVEF、PER、PFR、EV/AV均无显著性差异。结论 :收缩压或舒张压负荷值的升高均可显著影响高血压病患者的心室舒张功能 ,而后者为著。同时舒张压负荷值与心室收缩功能明显相关 。

Objective: To investigate the effect of 24 hour ambulatory blood pressure loading value on cardiac contraction and relaxation function of essential hypertensive patient.Methods: Select 80 essential hypertensive patients. Use 24-hour ambulatory blood pressure monitoring and echocardiogram monitor cardiac function, and the dynamics index:left ventricular ejection fraction(LVEF), left ventricular peak filling rate(PFR), left ventricular peak ejection rate (PER), and the ratios (EV/AV) of mitral blood flow relaxation early velocity (EV) to left atrium contraction flow velocity (AV). According to the blood pressure loading value <30% and >30%,the patients are divided into 4 teams:A,B,C, and D, compare their cardiac function's deference.Results: To compare A with B,PFR is obviously different; To compare A with C,D separately, LVEF and EV/AV are greatly different( P <0 05);and PFR differ sharply ( P <0 01);To compare C with D, LVEF, PER, PFR, and EV/AV has no obvious difference. Conclusion: The rising blood pressure loading value both systolic and diastolic can make greatly effect on ventricular diastolic function, and the second one is more obviously. At the same time, diastolic pressure loading value correlated obviously with ventricular contraction function, so it can be used as sensitive index to prognosticate the cardiac function change of the patient who has this disease.