高血压患者动态血压与左心室舒张功能关系的探讨——附44例分析

The relationship between the ambulatory blood pressure and left ventricular diastolic function in patients with essential hy－perten sion．

目的:分析高血压患者动态血压与左心室舒张功能的关系。方法:应用无创动态血压监测系统及彩色多普勒超声心动描记术对44例高血压患者和年龄匹配的同期住院的无器质性心脏病及糖尿病病史的10例病人(对照组)进行检测,并对检测结果作对比分析。结果:①高血压组患者未发现有收缩功能异常,发现舒张功能下降的有24例,占54%;②根据二尖瓣血流A峰速度(A)与E峰速度(E)的大小分组,A>E组患者的23时01分至7时00分时段及24小时平均收缩压均高于A<E组<0.05,具有统计学意义;7时01分至23时00分时段的平均收缩压也有增高的趋势,但=0.08,未达到统计学差异;③经多元回归分析,发现A/E值与年龄和24小时平均收缩压(SBP)呈正相关,回归方程:=-2.306+0.02501×年龄+0.01549×24hSBP,确定系数2=0.64。结论:高血压患者的平均收缩压较高者,其左心室舒张功能受累的机会也较高,A/E比值与年龄及24小时平均收缩压具有相关性。

Objective：To determine the relation of２４－hour bl ood pressure（BP）and its different phase with left ventricular diastolic funct ion in patients with hypertension．Methods：４４patients with hypertension were studied by Ambulatory BP recording and Doppler echocardiography．Results：①No patient in this study was suffered from systolic dysfunction．Impaired diastoli c function was found in２４patients，account for５４％．②In group A＞E．２４－ hour average systolic blood pressure（SBP）and nighttime SBP were high－er than the group A＜E（P＜０．０５），Daytime SBP in group A＞E was higher than group A＜E（P＝０．０８），It's no difference in signifi－cance．③In a multivariate m odel，only age（β＝０．０２５０１，P＝０．００２）and２４－hour SBP（β＝０． ０１５４９，P＝０．０２２）were correlated pos－itively to the ratio A／E in the pooled population．Conclusion：Left ventricular diastolic function is related t o２４－hour SBP and age．