心内科高血压患者的动态血压与其多普勒心肌做功指数的相关性分析

Correlation analysis of ambulatory blood pressure with doppler myocardial performance index in hyperpietics in department of cardiology

目的研究心内科原发性高血压(高血压)患者的动态血压与其多普勒心肌做功指数(myocardial performance index,MPI)的相关性。方法选取周至县人民医院心内科2014年2月至2015年2月收治的高血压患者82例作为研究对象,进行24 h动态血压监测和超声心动图检查。计算出所有患者的左心室MPI,公式为MPI=[等容收缩时间(isovolumetric contraction time,ICT)+等容舒张时间(isovolumic relaxation time,IRT)]/射血时间。将MPI>0.47的患者定为研究组和MPI≤0.47的患者定为对照组。比较两组患者动态血压指标以及超声心动图参数的变化情况,并用多因素线性回归分析来确定MPI的独立相关因素。结果研究组24 h、日间平均收缩压,24 h、日间和夜间舒张压,24 h、日间收缩压标准差以及左心室质量指数(left ventricular mass index,LVMI)、ICT、IRT、MPI均明显高于对照组;而Em(舒张早期运动峰速度)、射血时间均明显低于对照组,上述差异均有统计学意义(P<0.05)。用逐步后退法进行多因素回归分析显示,24 h平均舒张压、24 h收缩压标准差、LVMI以及Em是MPI的独立影响因素。结论高血压患者舒张压升高和收缩压标准差的增加伴随左心室MPI的升高,24 h平均舒张压、24 h收缩压标准差、LVMI以及Em是MPI的独立影响因素。

Objectives To conduct a correlation study of ambulatory blood pressure with Doppler myocardial performance index（MPI） in hyperpietics in Department of Cardiology. Methods Totally 82 patients with hypertension treated in Department of Cardiology of Zhouzhi County People′ s Hospital from February 2014 to February 2015 were chosen as the research objects examined by 24 h ambulatory blood pressure monitor and echocardiography. Left ventricular MPI was calculated in all the patients by the formula MPI = [ isovolumetric contraction time（ ICT） ＋ isovolumetric relaxation time（IRT） ] / ejection time. Patients with MPI 〉0.47 were enrolled in research group and patients with MPI≤0.47 in control group. Changes of ambulatory blood pressure indexes and echocardiographic parameters of the two groups were compared. Multi-factor linear regression analysis was used to determine the independent factors associated with MPI. Results 24 h and daytime average systolic blood pressures, 24 h, daytime and nighttime diastolic blood pressures, 24 h and daytime systolic blood pressure standard deviations, left ventricular mass index（LVMI）, ICT,IRT and MPI were significantly higher in research group than in control group; while peak early diastolic velocity（Em）and ejection time（ET） were significantly lower. These differences were statistically significant（P〈0.05）. Multiple stepwise regression analysis showed that 24 h average diastolic blood pressure, 24 h systolic blood pressure standard deviation, LVMI and Em were independent factors of MPI. Conclusions Diastolic blood pressure and systolic blood pressure standard deviation increase with the rise of left ventricular MPI in hypertensive patients. 24 h average diastolic blood pressure, 24 h systolic blood pressure standard deviation, LVMI and Em are independent factors of MPI.