原发性高血压患者血压变异性与左室肥厚的相关性研究

Correlation between blood pressure variability and left ventri-cular hypertrophy in patients with primary hypertension

目的 :探讨原发性高血压患者血压变异性与左室肥厚的关系。方法 :对 87例高血压病患者及 2 6例正常人 (对照组 )进行 2 4h动态血压监测 (ABPM)和超声心动图左室重量指数 (LVMI)的测定。结果 :高血压病组LVMI显著高于对照组 ;相关分析结果显示 ,高血压病组的LVMI与 2 4h平均收缩压 (2 4h SBP)、夜间平均收缩压 (n SBP)及舒张压 (n DBP)呈显著正相关 (分别为r =0 .183,P <0 .0 5 ;r =0 .2 75 ,P <0 .0 1;r =0 .2 4 3,P <0 .0 5 ) ,与 2 4h收缩压变异性 (2 4h SBPV)、白昼收缩压变异性 (d SBPV)呈显著负相关 (分别为r =- 0 .2 5 3,P <0 .0 1;r =- 0 .186 ,P <0 .0 5 ) ;高血压病组伴左室肥厚 (LVH)者 2 4h SBPV显著低于无LVH者 ,而d SBPV和夜间收缩压变异性 (n SBPV)在两者间差异无显著性。结论 :2 4h

Objective To study the correlation between blood pressure variability (BPV)and left ventricular hypertrophy (LVH)in patients with primary hypertension. Methods We monitored the 24 hour ambulatory blood pressure and determined the left ventricular mass index (LVMI)by two dimensional echocardiography in 87 patients with primary hypertension (PH) and 26 normal controls. Results The LVMI in the PH patients was significantly higher than that in the controls. It was positively correlated to the average level of the 24 hour systolic blood pressure (24 h SBP), nighttime systolic blood pressure (n SBP), and nighttime diastolic blood pressure (n DBP)( r=0.183, P<0.05; r=0.275,P<0.01; r=0.243,P<0.05,respectively). It was also negatively correlated to the 24 hour systolic blood pressure variability (24 h SBPV) and the daytime systolic blood pressure variability (d SBPV)(r=-0.253,P<0.01;r=-0.186,P<0.05,respectively).The 24 h SBPV in the patients with LVH was significantly lower than that of those without LVH, but there was no significant difference in d SBPV and n SBPV between the PH patients with LVH and those without LVH. Conclusion The 24 h SBPV is valuable in predicting LVH in hypertension.