充血性心力衰竭患者动态血压的变化及意义

目的 探讨慢性充血性心力衰竭（ＣＨＦ）患者２４ｈ动态血压的变化及意义。方法 将５７例ＣＨＦ患者按心功能的受损程度（ＮＹＨＡ分组）分为Ａ组（１７例，心功能Ⅱ组）、Ｂ组（１９例、心功能Ⅲ级）和Ｃ组（２１例，心功能Ⅳ级）；根据病因的不同，分为Ｄ组（１６例，扩张型心肌病）和Ｅ组（４１例，非扩张型心肌病）；全部患者行２４ｈ动态血压（２４ｈ ＡＢＰ）检查，比较Ａ，Ｂ，Ｃ三组及Ｄ、Ｃ两组之间平均收缩压、夜间平均收缩压下降率（ｎｓＢＰＲ）及２４ｈ平均收缩压变异率（２４ｈ ｓＢＰＶ）的差异。结果 Ｃ组的平均收缩压较Ａ组和Ｂ组略低，但三组之间差异无显著性（Ｐ〉０．０５）；Ｄ组的平均收缩压显著低于Ｅ组（Ｐ〈０．０５）。Ａ，Ｂ，Ｃ３组的ｎｓＢＰＲ减弱或消失，分别占５８．８％，８８．３％和９５．２％，Ａ组与Ｂ，Ｃ，组的平均收缩压显著低于

Changes and clinical significance of ambulatory blood pressure monitoring in patients with congestive heart failure

Objective To study the changes and clinical significance of 24 hour ambulatory blood pressure monitoring (ABPM) in patients with congestive heart failure (CHF). Methods 57 patients with CHF were divided into three gropus: group A(n=17, heart function class Ⅱ), group B(n=19, heart function class Ⅲ), group C (n=21, heart function class V). According to different causes, these patients were divided into group D (n=19, dilated cardiomyopathy) and group E(n=41,non-dilated cardiomyopathy). All patients were monitored by 24 hour ABPM. Mean systohc pressure, night systolic pressure drop rate (nsBPR) and 24 hours mean systolic pressure variability (24 h sBPV) were compared. Results Mean systolic pressure in group C were slightly lower than those group A and group B. But there were not significant differences among group A, B and C (P>0.05). Mean systolic pressure in group D were significantly lower than that in group E (P<0.05). The nsBPR in group A, B and C were 58. %, 88.3%, and 95.2%. There were significantly differences in nsBPR between the group A and B or C (P<0.05 and <0.01). The 24 h sBPV in group A, B and C was 9.7,8.8 and 8.7. There were significantly differences between group A and group B or C (P<0.01). Conclusion Mean systolic pressure with CHF decreases. Day and night rhythms of blood pressure with CHF were reduced or disappeared. 24 h sBPR was reduced. These changes were positively correlated with the degree of CHF.