夜间高血压对原发性高血压患者心功能及肾功能的影响研究

Impact of Nocturnal Hypertension on Cardiac Function and Renal Function of Patients with Essential Hypertension

目的探讨夜间高血压对原发性高血压(EH)患者心功能及肾功能的影响。方法选取中山市阜沙医院心血管内科2013年7月—2014年7月收治的EH患者92例,均进行24 h动态血压监测,根据患者是否合并夜间高血压分为合并夜间高血压组43例和未合并夜间高血压组49例。比较两组患者基线资料〔包括体质指数(BMI)、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)〕、日间血压(日间收缩压和日间舒张压)和夜间血压(夜间收缩压和夜间舒张压)、心功能指标〔左心室舒张末期内径(LVDd)、室间隔厚度(IVST)、左心室后壁厚度(IVPWT)、左心室射血分数(LVEF)、左心室舒张早期充盈峰值流速/舒张晚期充盈峰值流速(E/A)比值〕及肾功能指标〔血清β2微球蛋白(β2-MG)、尿素氮(BUN)、肌酐(Cr)及尿β2-MG水平〕。结果两组患者BMI、FPG、TC、TG、日间收缩压及日间舒张压比较,差异无统计学意义(P>0.05)。合并夜间高血压组患者夜间收缩压和夜间舒张压高于未合并夜间高血压组(P<0.05)。合并夜间高血压组患者LVDd、IVST、IVPWT及E/A比值高于未合并夜间高血压组,LVEF低于未合并夜间高血压组(P<0.05)。合并夜间高血压组患者血清β2-MG、BUN、Cr及尿β2-MG水平高于未合并高血压组(P<0.05)。结论夜间高血压对EH患者心功能和肾功能均会造成一定程度的损害。

Objective To explore the impact of nocturnal hypertension on cardiac function and renal function of patients with essential hypertension. Methods From July 2013 to July 2014,a total of 92 patients with essential hypertension were selected in the Department of Cardiovasology,Fusha Hospital of Zhongshan,all of them received 24 -hour ambulatory blood pressure monitoring,and they were divided into A group（with nocturnal hypertension,n=43）and B group（without nocturnal hypertension,n =49）according to the incidence of nocturnal hypertension. Baseline data（including BMI,FPG, TC,TG）, daytime blood pressure （ including daytime systolic pressure and daytime diastolic pressure ）, nighttime blood pressure（ including nighttime systolic pressure and nighttime diastolic pressure ）, cardiac function index （ LVDd, IVST, IVPWT,LVEF,E/A ratio） and renal function index （ serum β2 - MG, BUN, Cr levels and urine β2 - MG level ） were compared between the two groups. Results No statistically significant differences of BMI,FPG,TC,TG,daytime systolic pressure or daytime diastolic pressure was found between the two groups （ P〉0. 05 ）, while nighttime systolic pressure and nighttime diastolic pressure of A group were statistically significantly higher than those of B group（P〈0. 05）. LVDd,IVST, IVPWT and E/A ratio of A group were statistically significantly higher than those of B group, while LVEF of A group was statistically significantly lower than that of B group（P〈0. 05）. Serumβ2 -MG,BUN,Cr levels and urineβ2 -MG level of A group were statistically significantly higher than those of B group（P〈0. 05）. Conclusion Nocturnal hypertension can induce cardiac function damage and renal function damage in a certain extent.