高血压病血压昼夜节律与左室肥厚关系的研究

Study on the Relationship between LVH and Circardian Rhythythm of Hypertensive Patients

目的 探讨血压负荷(BPL)与高血压靶器官损伤程度的关系,以及左室重量指数(LVMI)与动态血压(Ambulatory Blood Pressure,ABP)各参数之间的相关性。方法 采用无创性携带式动态血压监测仪对30例正常血压者,1级和2级高血压患者各25例进行了动态血压监测,同时用超声心动图检测左室重量指数。结果(1)正常组与1级高血压组之间血压负荷(SBP:4.83±2.95％vs59.75±22.12％;DBP:3.75±2.05％vs 61.75±18.24％)比较有显著性差异(P均<0.01);1级高血压组昼夜负荷差较大,呈杓型改变。2级高血压组的血压负荷(SBP:94.94±5.08％vs59.75±22.12％;DBP:91.75±10.08％vs61.75±18.24％)明显高于1级组(P均<0.01)。昼夜负荷呈非杓型改变。2级组左室肥厚(LVH)异常检出率76％明显高于1级组20％(P<0.01)。(2)高血压组LVMI与夜间SBP和DBP均显著正相关(P均<0.01),与夜间SBP和DBP下降率均显著负相关(P均<0.01)。结论 血压负荷对高血压靶器官损害程度的评价和预测有临床价值。夜间SBP与LVMI的相关性比DBP与LVMI的相关性更佳。

Objective To investigate the relationship between blood presure load (BPL) and the damage degree of target organ (TOD) and the correlation between LVMI and ABP parameters. Methods 30 normotensives, 25 patients with grade 1 hypertension, 25 patients with grade 2 hypertension were measured by ABPM, while left ventricular mass index (LVMI) was measured by ecocardiography. Results (1) There was a significant difference between the blood presure load values of normotensive group and grade 1 hypertension group (SBP 4. 83 ± 2. 95% vs 59. 75 ± 22. 12% ) DBP 3. 15±2, 05% vs 61. 75± 18. 24%) (P<0. 01). The blood pressure load values of grade 2 hypertension group were obviously higher than thoese of grade 1 hypertension group (SBP 94.94±5.08% vs 59. 75± 22. 12% ; DBP 91.75± 10. 08% vs 61. 75±18. 24%) (P<0. 01). The abnormality rate of LVH in grade 2 hypertension group was higher than that in grade 1 hypertension group (76% vs 20%). (2) There was a significantly positive correlation between LVMI and nighttime SBP and nighttime DBF in hypertension group (P<0. 01), and there was a significantly negative correlation between LVMI and reducing rate of nighttime SBP and DBP in hypertension group (P<0. 01). Conclusions Blood pressure load are closely associated with the damage degree of TOD in hypertension. The correlation between LVMI and levels of nighttime SBP was better than that of nighttime DBP.