动态血压水平和血压变异性与心肌做功指数的相关性

Correlation of ambulatory blood pressure level and blood pressure variability with myocardial performance index

目的分析动态血压水平和血压变异性与心肌做功指数(MPI)的相关性。方法选取我院2015年5月至2016年5月收治的109例高血压患者为研究对象,监测患者24 h动态血压及超声心动图,计算患者的MPI。根据患者的左心室MPI分为MPI≤0.46组57例和MPI>0.46组52例,比较两组患者24 h及日间、夜间三个时段的动态血压平均值和标准差,采用标准差评价患者血压变异性,采用多因素Logistic回归分析影响MPI的因素。结果 MPI>0.46组患者的日间和24 h平均收缩压水平及其标准差、以及该组在三个时段的平均舒张压水平均高于MPI≤0.46组患者,差异均有统计学意义(P<0.05);MPI>0.46组患者的等容收缩时间、等容舒张时间与高血压病程均大于MPI≤0.46组患者,而射血时间低于MPI≤0.46组患者,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,24 h平均舒张压及24 h收缩压标准差是MPI的独立影响因素。结论高血压患者的动态血压水平和血压变异性与心肌做功指数存在一定相关性,可能导致左心室功能降低。

Objective To analyze the correlation of ambulatory blood pressure and blood pressure variability with myocardial performance index（MPI）. Methods A total of 109 hypertensive patients, who admitted to our hospital from May 2015 to May 2016, were enrolled. The ambulatory blood pressure and echocardiography of all patients within24 hours were measured and the MPI of the patients was calculated. The patients were divided into MPI≤0.46 group（n=57） and MPI0.46 group（n=52） according to their left ventricular MPI. The mean and standard deviation of ambulatory blood pressures at 24 hours, days and night between two groups were compared, and the blood pressure variabilities were evaluated by standard deviation. The independent influencing factors of MPI were analyzed by multivariate logistic regression analysis. Results The average systolic blood pressure and its standard deviation at day and 24 hours, and the average diastolic blood pressure levels in three periods in the MPI0.46 group were significantly higher than those in the MPI≤0.46 group（P0.05）. The isovolumic contraction time, isovolumic relaxation time and the duration of hypertension in the MPI0.46 group were significantly longer than those in the MPI≤0.46 group, and the time of ejection in the MPI0.46 group was significantly shorter than that in the MPI≤0.46 group（P0.05）. Multivariate logistic regression analysis showed that the mean diastolic blood pressure and the standard deviation of 24-hour systolic blood pressure were independently influencing factors of MPI. Conclusion The dynamic blood pressure and blood pressure variability of hypertensive patients may be related to MPI, which may lead to the decrease of left ventricular function.