动态血压与动态心电图联合在肾实质性高血压监测中的作用

Correlation between dynamic blood pressure combined with dynamic electrocardiogram and renal substantive hypertension

目的研究动态血压和动态心电图与肾实质性高血压的相关性。方法选取2016年10月至2017年12月接受治疗的确诊为肾实质性高血压患者50例为观察组,同期治疗的原发性高血压患者50例为对照组。对2组患者同时进行24 h动态血压和动态心电图同步监测,分析动态血压和动态心电图与肾实质性高血压之间的关系。结果观察组24 h平均收缩压(24 h SBP)、白天平均收缩压(dSBP)、夜间平均收缩压(nSBP)、非杓型血压均高于对照组,差异有统计学意义(P<0.05),而2组24 h平均舒张压(24 h DBP)、白天平均舒张压(dDBP)、夜间平均舒张压(nDBP)差异无统计学意义(P>0.05)。观察组夜间ST-T改变、心律失常发生率高于对照组,差异有统计学意义(P<0.05)。结论非杓型血压、夜间收缩压、夜间ST-T改变、心律失常发生率肾实质性高血压患者均高于原发性高血压患者,收缩压的监测参数与肾性高血压患者肾功能密切相关,与舒张压无明显相关性。

Objective To investigate the correlation between dynamic blood pressure combined with dynamic electrocardiogram and renal substantive hypertension.Methods A total of 50 patients with confirmed renal substantive hypertension who were treated in our hospital from October 2016 to December 2017 were enrolled as observation group,and the other 50 patients with essential hypertension who were hospitalized at the same period were enrolled as control group.The simultaneous monitoring of dynamic blood pressure and dynamic electrocardiogram for 24 hours was performed in both groups,and the correlation between dynamic blood pressure combined with dynamic electrocardiogram and renal substantive hypertension was analyzed.Results The levels of 24h mean systolic blood pressure(SBP),the average systolic blood pressure during the day(dSBP)and night(nSBP),and non dipper type blood pressure in observation group were significantly higher than those in control group(P<0.05),however,there were no significant differences in the 24h mean diastolic pressure(DBP),dDBP and nDBP between the two groups(P>0.05).Moreover the incidence rates of nocturnal ST-T changes and arrhythmia in observation group were significantly higher than those in control group(P<0.05).Conclusion The incidence rates of non-arytenoid blood pressure,nocturnal systolic blood pressure,nocturnal nocturnal ST-T changes and arrhythmia in patients with renal substantive hypertension are higher than those of patients with with essential hypertension.The monitoring parameters of systolic blood pressure are closely related to renal function in patients with renal hypertension,however,which is not correlated with diastolic blood pressure.