原发性高血压患者家庭自测血压变异性与左心室应变率及Tei指数的相关性

Variability of self-measured blood pressure at home is related to left ventricular strain rate and Tei index in patients with essential hypertensive

目的探讨原发性高血压患者家庭自测血压变异性（HBPV）与左心室应变率及Tei指数的相关性。方法2012年9月～2014年5月对合格人选的233例进行7d家庭血压自我监测及心脏彩色超声检测。HBPV用最后连续6d的每日收缩压平均值的标准偏差（S）表示。根据HBPV三分位，将受试者分为低变异性组（79例），中变异性组（76例）和高变异性组（78例）。结果与高变异组比较，低及中变异组心尖部、中间段、基底段的SRe及SRa显著增高，SRs明显降低，差异有统计学意义（P〈0．05，P〈0．01）。与中变异组比较，低变异组心尖部SRe、中间段SRe及基底段SRa显著增高，心尖部及基底段SRs明显降低，差异有统计学意义（P〈0．05，P〈0．01）。高变异组Tei指数（0．41±0．06）显著高于低及中变异组，中变异组（0．38±0．07）显著高于低变异组（0．32±0．07），差异有统计学意义（P〈0．05）。HBPV与心尖部、中间段、基底段SRe及SRa呈显著负相关，与SRs及Tei指数呈显著正相关（P〈0．01）。结论原发性高血压患者HBPV与左心室应变率及Tei指数密切相关。

AIM To explore the relationship between the variability of self-measured blood pressure at home （HBPV） and left ventricular strain rate and Tei index in essential hypertensive patients. METHODS From September 2012 to May 2014, 233 essential hypertensive patients were enrolled. Seven consecutive days self-measured blood pressure at home, strain rate of left ventricular segments, and Tei index were evaluated in all participations. According to tertile of systolic HBPV, participations were divided into low BPV group （ n = 79）, medium BPV group （ n -- 76） and high BPV group （ n -- 78）. RESULTS Compared with those in high BPV group, SRe and SRa of left ventricular apex, middle and basic section in low and medium BPV groups were significantly higher, and SRs of left ventricular apex, middle and basic section were markedly lower （P 〈0. 05, P 〈0. 01）. In low BPV group, SRe of left ventricular apex and middle section and SRa of left ventricular basic section were significantly higher, and SRs of left ventricular apex and basic section were markedly lower than those in medium BPV group （ P 〈 0. 05 ）. Tei index in high BPV group （0. 41 _＋0. 06） was significantly higher than that in low and medium BPV groups （0. 32 ＋0. 07 and O. 38 ＋_0. 07, respectively, P 〈0. 05, P 〈0. 01 ）. Tei index in medium BPV group was significantly higher than that in low BPV group （P 〈 0.05）. HBPV was closely correlated with SRe, SRa, SRs of left ventricular apex, middle and basic section and Tei index （P 〈 0. 01 ）. CONCLUSION The variability of self-measured blood pressure at home is closely correlated with left ventricular strain rate and Tei index in essential hypertensive patients.