动态脉压对高龄高血压病患者左室肥厚和左室功能的影响

Influence of ambulatory pulse pressure on left ventricular structure and function in very elderly patients with hypertension

目的 为探讨高龄高血压病患者动态脉压对左室肥厚和左室功能的影响。方法 根据动态脉压将患者分为两组 (年龄、性别差异无显著性 ) ,动态脉压 <6 0mmHg为A组 ,动态脉压≥ 6 0mmHg为B组。应用 2 4h动态血压监测和超声心动图方法观察并比较 6 8例年龄≥ 80岁的高血压病患者的动态脉压以及左室结构和功能的特点。结果 动态脉压≥ 6 0mmHg组较动态脉压 <6 0mmHg组的左室重量及左室重量指数明显增加 (P <0 0 1) ,舒张早期血流的峰值流速减慢 ;心房收缩期血流的峰值流速及A/E比值加大(P <0 0 5 )。结论 动态脉压高的高龄高血压患者较动态脉压低者更易导致左室肥厚和左室舒张功能减退。

Objectives To investigate the influence of ambulatory pulse pressure on left ventricular structure and function in very elderly patients (≥80 years old) with hypertension. Methods Sixty-eight very elderly patients (there was no significantly diffe-rence between two groups in age and gender) were divided into two groups according to their ambulatory pulse pressure (<60 mmHg into A group, ≥60 mmHg into B group). The ambulatory pulse pressure, left ventricular structure and function of sixty-eight very elderly patients with hypertension were measured respectively with ambulatory blood pressure monitor and echocardiography. Results Left ventricular mass and left ventricular mass index were significantly increased(P<0.01),peak flow velocity of early diastole was decreased, peak flow velocity of aterial contraction,and the ratio of A/E were increased in A group compared with those in B group (P<0.05). Conclusions Higher ambulatory pulse pressure could induce the increase of left ventricular hypertrophy and decrease of left ventricular diastole function in the very elderly patients with hypertension.