高血压合并肝硬化的血压特点及降压分析

Blood pressure characteristics and antihypertensive analysis of hypertension with liver cirrhosis

目的研究合并肝硬化的高血压患者血压的分布特点、血压负荷与肝功能分级的关系,希望能为临床此类患者的降压治疗用药提供一定指导。方法对123例患者行24 h动态血压监测,分别统计血压负荷、血压形态及相应时间段的肝功能分级,进行统计学分析处理。结果肝功能不同分级患者24 h血压形态比较,差异无统计学意义(P>0.05),多数患者也存在血压正常节律消失、夜间血压负荷增大的现象。肝功能A级与C级患者血压负荷比较,P<0.05,差异有统计学意义;肝功能A级与BC级(B级+C级,下同)患者血压负荷比较,P<0.05,差异有统计学意义;肝功能A与B级、B与C级患者血压负荷分别比较,P>0.05,差异无统计学意义。结论肝硬化合并高血压的患者也存在夜间血压负荷增大的现象,其中肝功能A级患者血压负荷高于C级、高于BC级;暂不能说明肝功能分级A级患者血压负荷高于B级、B级患者血压负荷高于C级。

Objective To study the blood pressure distribution characteristics and the relationship between blood pressure load and liver function grades among sufferers with hypertension and liver cirrhosis, so as to provide some clinical guidance for antihypertensive therapeutic medication of these sufferers. Methods 123 patients were given 24-hour ambulatory blood pressure monitoring, and blood pressure load, blood pressure forms and liver function grades in the corresponding periods were respectively recorded for statistical analysis. Results Comparison of 24-hour ambulatory blood pressure forms among sufferers with different liver function grades showed differences of no statistical significance （P 〉 0.05）.Most sufferers had disappearance of normal blood pressure rhythm and increase of nighttime blood pressure load,Comparison of blood pressure load between sufferers of liver fimction grade A and C showed difference of statistical significance （P 〈 0.05 ）. Comparison of blood pressure load between sufferers of liver function grade A and BC （B ＋C） showed difference of statistical significance（P〈 0.05 ）.Comparison of blood pressure load between sufferers of liver function grade A and B, B and C showed difference of no statistical significance （P 〉 0.05）.Conclusion Sufferers with hypertension and liver cirrhosis also have the occurrence of increase of nighttime blood pressure load, among which blood pressure load in sufferers of liver function grade A was higher than that in sufferers of liver function grade C, and BC. But it is not clear to say blood pressure load in sufferers of liver function grade A was higher than B, or blood pressure load in sufferers of liver function grade B was higher than C.