老年高血压患者左心室肥厚与动态脉压及动态脉压指数的关系

Relationship of left ventricular hypertrophy with ambulatory pulse pressure and ambulatory pulse pressure index in elderly patients with hypertension

目的探讨老年高血压患者左心室肥厚与动态脉压(24h APP)及动态脉压指数(24h APPI)的关系。方法入选我院住院确诊的老年高血压患者191例,入选患者均进行24 h无创动态血压监测,按24hAPP分为低脉压组(24hAPP<60 mmHg,n=136)和高脉压组(24hAPP≥60 mmHg,n=55);所有患者均行超声心动图检查,并记录左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)的数值,计算左心室质量指数(LVMI)。结果高脉压组24hAPPI、LVMI、24 h收缩压(24hSBP)的水平大于低脉压组;简单线性回归分析提示:年龄、24hAPP、24hAPPI、24hSBP为左心室肥厚的危险因素;多元逐步线性回归分析提示24hAPPI为LVMI的独立危险因素。结论 24hAPPI可能为老年高血压患者左心室肥厚的独立危险因素。

Objective To investigate the relationship of left ventricular hypertrophy with ambulatory pulse pressure（APP） and ambulatory pulse pressure index（ APPI） in the elderly patients with hypertension. Methods A total of 191 patients were divided into two groups： low pulse pressure group（ 24hAPP 60 mmHg,n = 136） and high pulse pressure group（24hAPP≥60 mmHg,n = 55） based on 24 h ambulatory blood pressure monitoring. All patients received detection of echocardiography. Left ventricular end-diastolic dimension（ LVEDD）,interventricular septal thickness（IVST） and left ventricular posterior wall thickness（LVPWT） were recorded. Left ventricular mass index（ LVMI） was calculated. Results The levels of 24hAPPI,LVMI and 24 h systolic blood pressure（24hSBP） in high pulse pressure group were higher than those in low pulse pressure group（0. 48± 0. 05 vs. 0. 39± 0. 06; 104. 8± 21. 6 g / m^2 vs. 97. 36 ± 17. 7g / m^2,141±11 mmHg vs.122±11. 4 mmHg）.The result of simple linear regression showed that age,24hAPPI,24hAPP and 24 h SBP were the risk factors of left ventricular hypertrophy. The results of stepwise multivariate linear regression showed that 24hAPPI was the independent risk factor of left ventricular hypertrophy. Conclusions 24hAPPI may be the independent risk factor of left ventricular hypertrophy in the elderly patients with hypertension.