急性心肌梗死患者血压变异性与心室重构的相关性研究

Correlation between blood pressure variability and ventricular remodeling in patients with acute myocardial infarction

目的探讨急性心肌梗死患者血压变异性(BPV)与心室重构(VR)的相关性。方法回顾性分析2013年5月至2015年6月于我院心内科诊治的急性心肌梗死患者189例临床资料,根据24 h收缩压BPV的总变异系数(coefficient variation,CV)将患者分为对照组(≤12.16%)和观察组(>12.16%),并选取同期正常体检患者60例为正常组。记录三组患者不同时段BPV值,比较患者治疗前及治疗后6个月超声心动图检结果,并进行BPV与心室重构的相关性分析。结果与正常组比较,对照组与观察组患者的各时段SBPV、DBPV均明显升高(P<0.05);与对照组比较,观察组患者各时段SBPV、DBPV均明显升高(P<0.05)。超声心动图结果显示,治疗前比较,对照组与观察组患者各项指标均明显高于正常组,差异具有统计学意义(P<0.05);治疗6个月后,对照组与观察组的LVEDV、LVESV及LVEF均较治疗前升高,且观察组患者LVEDV及LVESV明显高于对照组,而LVEF明显低于对照组,差异具有统计学意义(P<0.05)。患者的24 h收缩压BPV与LVEDV、LVESV指标间在对照组(r=0.758、0.604,P均<0.05)和观察组(r=0.794、0.613,P均<0.05)中均具有正相关性。结论急性心肌梗死患者BPV与其心室重构存在相关性,对判断AMI患者病情及预后具有一定的临床意义。

Objective To analyze the correlation between blood pressure variability and ventricular remodeling in patients with acute myocardial infarction. Methods Totally 189 patients with acute myocardial infarction who received treatment in our hospital from May 2013 ~ June 2015 were selected,and were divided into observation group（ CV12.16%） and control group（ CV12.16%）,and 60 cases were chosen as normal group.BPV values of three groups were recorded at different times,and the echocardiography results were compared among the patients before treatment and after 6 months of treatment,then analyzed the correlation of ventricular remodeling and BPV. Results Compared with the normal group,the control group and observation group in each period of SBPV and DBPV were significantly increased（ P〈0. 05）; Compared with the normal group,control group and observation group of patients in each period of SBPV and DBPV were significantly increased（ P〈0.05）; compared with the control group,the SBPV and DBPV at each period in the observation group were significantly increased（ P〈0.05）.Echocardiography showed that before treatment,indicators in the control group and the observation group were significantly higher than that of the normal group（ P〈0. 05）; After 6 months of treatment,LVEDV,LVESV,LVEF in control group and observation group were increased,and LVEDV and LVESV in observation group was significantly higher than that of the control group,while LVEF was significantly lower（ P〈0. 05）. The LVEDV,LVESV indicators had positive correlation with BPV of 24 h systolic blood pressure in the control group（ r = 0.758,0.604,P were 0.05） and the observation group（ r = 0.794,0.613,P〈0.05）. Conclusions There is a certain correlation between BPV and ventricular remodeling in patients with acute myocardial infarction,which has a clinical significance to judge the severity and prognosis of AMI patients.