高血压患者动态血压变异性与左心室肥厚的关系探讨

The relation between ambulatory blood pressure variability and left ventricular hypertrophy in patients with hypertension

目的 探讨高血压患者动态血压变异性与左心室肥厚（LVH）的关系.方法 选择高血压患者160例,分别给予24 h动态血压监测和超声心动图检查,根据心脏超声检查结果有无LVH,分为LVH组（n=70）和非LVH组（n=90）,比较2组动态血压各参数的变化,统计分析各时间段血压均值及血压变异性与LVH的关系.结果 ①LVH组与非LVH组的年龄、性别构成比较差异无统计学意义（P＞0.05）.②LVH组与非LVH组的24 h平均收缩压、24 h收缩压标准差、24 h舒张压标准差、白昼平均收缩压、白昼收缩压标准差、白昼平均舒张压、白昼舒张压标准差、夜间平均收缩压、夜间收缩压标准差、夜间平均舒张压、夜间舒张压标准差比较,差异均有统计学意义[分别为（152±14）mmHg（1 mmHg=0.133 kPa）比（121±9）mmHg、（18±4）mmHg比（82±5）mmHg、（16 ±5）mmHg比（11±4）mmHg、（153±11） mmHg比（123±10） mmHg、（17±5）mmHg比（13±4） mmHg、（100±9）mmHg比（83±6）mmHg、（16±5） mmHg比（10±3）mmHg、（147±14）mmHg比（112±12）mmHg、（15±6）mmHg比（10±4） mmHg、（96±10） mmHg比（77±8）mmHg、（14±6） mmHg比（8±3） mmHg]（均P＜0.01）.结论 高血压患者动态血压参数及血压变异性异常与LVH关系密切;血压变异性大者,LVH发生率增加.

Objective To investigate the relation between ambulatory blood pressure variability and left ventricular hypertrophy（LVH） in patients with hypertension.Methods We evaluated 160 patients with essential hypertension.All patients underwent ultrasound examinations of the heart and 24h ambulatory blood pressure monitoring（ABPM）.The patients were divided,according to with or without left ventricular hypertrophy,into left ventricular hypertrophy group （n =70） and non-left ventricular hypertrophy group （n =90）.The characteristics of ambulatory blood pressure and blood pressure variability were compared and analyzed between two groups.Results ①There were no significant differences in age and constituent ratio of gender between the LVH and no LVH groups （P 〉0.05）.②The parameters o f ABPM in LVH group were higher than those in no LVH group.There were significant differences（P 〈0.01） in 24 h mean systolic blood pressure,24 h systolic blood pressure standard deviation,24 h diastolic blood pressure standard deviation,daytime mean systolic blood pressure,daytime mean systolic blood pressure standard deviation,daytime mean diastolic blood pressure,daytime mean diastolic blood pressure standard deviation,nighttime mean systolic blood pressure,nighttime mean systolic blood pressure standard deviation,nighttime mean diastolic blood pressure,nighttime mean systolic blood pressure standard deviation [（152 ±14） mmHg vs （121 ±9）mmHg,（18 ±4）mmHg vs （82 ±5）mmHg,（16 ±5） mmHg vs （11 ±4）mmHg,（153 ±11）mmHg vs （123 ± 10）mmHg,（17 ±5） mmHg vs （13 ±4）mmHg,（100 ±9）mmHg vs （83 ±6） mmHg,（16 ±5） mmHg vs （10 ± 3） mmHg,（147 ± 14） mmHg vs （112 ± 12） mmHg,（15 ± 6） mmHg vs （10 ± 4） mmHg,（96 ±10） mmHg vs （77±8） mmHg,（14 ±6）mmHg vs （8 ±3）mmHg].Conclusion The ABPM parameters and blood pressure variability are correlated to LVH.