原发性高血压伴左室肥厚患者血压昼夜节律、血压负荷及其变异性的研究

The Rhythm, Load, and Variability of Blood Pressure in Essential Hypertension with Left Ventricular Hypertrophy

目的:探讨原发性高血压(EH)患者血压昼夜节律、血压负荷及血压变异性对左室肥厚(LVH)影响。方法:对确诊的60例EH患者行24h动态血压和超声心动图检测。结果:EH伴LVH与无LVH两组24h平均收缩压(SBP)及昼间平均SBP有显著性差异(P<0.01,P<0.05);夜间平均SBP、平均舒张压(DBP)有显著性差异(P<0.01,P<0.05)。两组24h收缩压负荷(SBP load)及舒张压负荷(DBP load)有显著性差异(P<0.05),昼间均无显著性差异(P>0.05),夜间SBP load及DBP load均有显著性差异(P<0.05)。昼间收缩压标准差(ABPVs)有显著性差异(P<0.05),夜间ABPVs及舒张压标准差(ABPVd)有显著性差异(P<0.05)。结论:原发性高血压伴左心室肥厚者其血压负荷及血压变异明显增大。夜间血压和左心室肥厚的关系更为密切。

Objective: To study the effects of blood pressure rhythm, blood pressure load (BP load), and blood pressure variability (ABPV) on left ventricular hypertrophy (LVH) in essential hypertension (EH). Methods: Sixty patients with EH were divided into two groups, with LVH and without LVH. All patients received 24 h ambulatory blood pressure measurement (24-ABPM) arid two-dimensional echocardiography measurement. Results: The 24h average systolic blood pressure (SBP), daytime average SBP, nighttime average SBP, and diastolic blood pressure (DBF) were significantly higher in EH with LVH than that in EH without LVH; 24h SBP load and DBF load, daytime SBP load, and DBF load were significantly higher in EH with LVH than that without LVH, and no significant difference was found in daytime SBP load and DBF load between two groups. Daytime SBP variability (ABPVs) , nighttime ABPVs, and nighttime DBF variability (ABPVd) in EH with LVH were significantly higher than that without LVH. Conclusion: Blood pressure rhythm, BP load, and BPV can be used to predict the occurrence of LVH, and the level of nighttime BP may have more intimate relation with LVH.