收缩压及昼夜节律对左室肥厚的影响

目的探讨老年高血压病患者收缩压、昼夜节律对左室肥厚（LVH）的影响。方法对141例老年高血压病患者进行24h动态血压监测（ABPM）,根据左室质量指数（LVMI）将其分为LVH组（A组）63例和非LVH组（B组）78例,比较两组动态血压参数与LVH的关系。结果（1）A组与B组比较,24hSBP、dSBP、nSBP、nDBP和24hPP差异有统计学意义（P〈0．01或0．05）;（2）A组与B组杓型血压率差异有统计学意义（P〈0．01）;（3）LVMI与24hSBP、dSBP、nSBP、nDBP、24hPP正相关（r=0．140～0．479,P〈0．01或0．05）,与SBPF、DBPF负相关（r=-0．395,-0．376,P〈0．01）。结论老年高血压病患者收缩压水平、昼夜节律对左室肥厚的发生、发展有重要作用。

Influences of systolic blood pressure and circadian rhythms on left ventricular hypertrophy

Objective To investigate influences of systolic blood pressure and circadian rhythms on left ventricular hypertrophy （LVH） in elderly patients with essential hypertension. Methods Ambulatory blood pressure monitoring （ABPM） was taken in measurement 141 elderly patients with essential hypertension. According to LVMI, they were divided into LVH group （group A, n=63） and non-LVH group （group B, n=78）. The relationship between ABPM and LVMI was observed. Results （1） 24h SBP, dSBP, nSBP, nDBP and 24h PP in group A were higher than those in group B （P 〈 0.01 or P 〈 0.05）; （2） the rate of dipper type hypertension was significantly different between the two groups （P 〈 0.01）; and （3） 24h SBP, dSBP, nSBP, nDBP, and 24h PP were positively correlated with LVMI （r=0.140- 0.479, P〈 0.01 or P 〈0.05）, while SBPF and DBPF were negatively correlated with LVMI （r=-0.395, -0.376, P〈0.01）. Conclusions Systolic blood pressure and rhythmical changes of blood pressure during day and night play important roles in LVH.