原发性高血压患者血压变异性与左心室舒张功能的关系

Relationship between blood pressure variability and left ventricular diastolic function in patients with essential hypertension

目的探讨原发性高血压(高血压)患者血压变异性与左心室舒张功能的关系。方法选择2013年1月至2015年1月间来四川省德阳市人民医院就诊的高血压患者120例,根据E/Ea值将高血压患者分为两组,E/Ea<15为对照组(n=73),E/Ea≥15为观察组(n=47)。两组患者行24 h动态血压监测和实验室检查,观察心室舒张功能各评价指标的变化。结果观察组24 h平均舒张压(m DBP),夜间平均收缩压(n SBP),24 h舒张压变异系数(24 h DBPCV)均明显高于对照组,差异有统计学意义(P<0.05)。观察组24 h平均收缩压(m SBP),白天平均收缩压(d SBP),白天平均舒张压(d DBP),夜间平均舒张压(n DBP),24 h收缩压变异系数(24 h SBPCV)均高于对照组,但差异无统计学意义(P>0.05)。24 h平均收缩压标准差、24 h平均收缩压变异系数及心率与左心室舒张功能不全具有相关性(P<0.05)。结论高血压患者血压变异性与左心室舒张功能不全呈独立相关。

Objectives To investigate the relationship between blood pressure variability and left ventricular diastolic function in patients with essential hypertension. Methods Totally 120 patients with essential hypertension from January 2013 to January 2015 in The People＇s Hospital of Deyang City were chosen, and according to the E/EA value, they were divided into 2 groups including control group （n=73） for E/Ea〈15 and observation group （n=47） for E/EA ≥ 15. The 24-h ambulatory blood pressure monitoring, echocardiography and laboratory examination were performed to observe the changes in ventricular diastolic function. Results Mean diastolic blood pressure （mDBP）, average nighttime systolic blood pressure （nSBP） and coefficient of variation of 24-h diastolic blood pressure （24-hDBPCV） in observation group were significantly higher than those in control group （P〈0.05）. There were no significant differences in mean systolic blood pressure （mSBP）, average daytime systolic blood pressure （dSBP）, average daytime diastolic blood pressure （dDBP）, nighttime diastolic blood pressure （nDBP） and coefficient of variation of 24-h systolic blood pressure （24-hSBPCV） between the 2 groups （P〉0.05）. Multivariate Logistic regression analysis showed that left ventricular diastolic dysfunction was associated with 24-hSBP standard deviation, 24-hSBPCV and heart rate in this patient cohort （P〈0.05）. Conclusions High variability of SBP is correlated with left ventricular diastolic dysfunction in patients with hypertension.