原发性高血压患者动态血压参数与左室肥厚的关系

Relationship between ambulatory blood pressure parameters and left ventricular hypertrophy in patients with essential hypertension

目的:探讨原发性高血压患者24h动态血压参数与左室肥厚的关系。方法:选择我院收治的106例原发性高血压患者(高血压组)和50例健康志愿者(健康对照组)进行24h动态血压监测。原发性高血压组患者按临床情况分为Ⅰ期(43例)、Ⅱ期和Ⅲ期(63例),根据左室质量指数(LVMI)分为不伴左室肥厚(NLVH)组(56例)和伴左室肥厚(LVH)组(50例),对其血压负荷和血压变异监测指标进行比较。结果:与Ⅰ期高血压患者相比,Ⅱ和Ⅲ期患者的24hSBP负荷≥25%(20.93%比77.78%)、24h平均SBP(24hmSBP)≥130mmHg(30.23%比73.02%)、24hSBP标准差(24hSSD)≥11.9(16.27%比82.54%)比例显著升高(P均=0.001)。与健康对照组比较,NLVH组和LVH组日间平均DBP(dmDBP)、夜间平均DBP(nmDBP)、24hSBP负荷、24hDBP负荷和夜间SBP(nSBP)负荷均显著增加(P<0.05或<0.01);与NLVH组比较,LVH组的24hmSBP、夜间平均SBP(nmSBP)、日间SBP(dSBP)负荷、24hSSD和日间SBP标准差(dSSD)均显著增加(P<0.05或<0.01);与Ⅰ期高血压组比较,Ⅱ和Ⅲ期高血压组24hmSBP、nmSBP、24hSBP负荷、nSBP负荷、24hSSD、dSSD和夜间SBP标准差(nSSD)均显著增加(P<0.05或<0.01)。结论:原发性高血压患者24h动态血压参数与左室肥厚有密切关系,降低24h动态血压负荷和变异性可降低左室肥厚的风险。

Objective:To relationship between ambulatory 24h blood pressure parameters and left ventricular hypertrophy in patients with essential hypertension.Methods:A total of 106 EH patients(EH group)and 50 healthy volunteers(healthy control group)were selected from our hospital,and all subjects received 24h ambulatory blood pressure monitoring.According to clinical condition,EH patients were divided into stage I group(n=43),stage II and III group(n=63);according to left ventricular mass index(LVMI),they were divided into no left ventricular hypertrophy(NLVH)group(n=56)and LVH group(n=50),blood pressure load and blood pressure variability(BPV)indexes were compared among above groups.Results:Compared with stage I group,there were significant rise in percentages of 24hSBP load≥25%(20.93%vs.77.78%),24h mean SBP(24hmSBP)≥130mmHg(30.23%vs.73.02%)and 24hSBP standard deviation(24hSSD)≥11.9(16.27%vs.82.54%)in stage II and III group,P=0.001 all.Compared with healthy control group,there were significant rise in daytime mean DBP(dmDBP),nighttime mean DBP(nmDBP),24hSBP load,24hDBP load and nighttime SBP(nSBP)load in NLVH group and LVH group,P<0.05 or<0.01;compared with NLVH group,there were significant rise in 24hmSBP,nighttime mean SBP(nmSBP),daytime SBP(dSBP)load,24hSSD and daytime SBP standard deviation(dSSD)in LVH group,P<0.05 or<0.01;compared with stage I group,there were significant rise in 24hmSBP,nmSBP,24hSBPload,nSBP load,24hSSD,dSSD and nighttime SBP standard deviation(nSSD)in stage II and III group,P<0.05 or<0.01.Conclusion:The 24h blood pressure parameters is closely associated with left ventricular hypertrophy in patients with essential hypertension.Reducing 24h ambulatory blood pressure load and variability can reduce risk of left ventricular hypertrophy.